Trauma Surgery

Pediatric pressure-injury risk models show discrimination but high bias and poor applicability.

Twelve pediatric pressure-injury prediction models from nine studies had AUCs ranging 0.612–0.978, with seven >0.75. All models were rated high risk of bias by PROBAST and most had major applicability concerns. Calibration reporting and external validation were inconsistent; only two studies assessed clinical utility. Common methodological flaws included low events-per-variable, poor missing-data handling, and single-center development. 1

Protocol to quantify attrition timing in hand and wrist trauma RCTs.

This protocol will meta-analyze attrition at predefined intervals: 30 days, 90 days, 6 months, and 12 months. It targets prospective randomized trials of hand and wrist trauma to identify at-risk patients and key loss-to-follow-up timepoints. Planned subgroup analyses include demographics, intervention type, and injury characteristics to inform retention strategies. Results aim to produce a toolkit to improve follow-up and reduce attrition bias in future trials. 2

nMT+ (ISS>15 or trauma-team actions) improves mortality discrimination versus ISS alone.

Using 2,676,710 NTDB records, nMT+ classified 22.4% as major trauma and had AUROC 0.83 for 24-hour mortality. nMT+ identified 29% more in-hospital deaths and 26% more 24-hour deaths than ISS>15 or HITS alone. HITS alone had the highest positive likelihood ratio for 24-hour mortality, but nMT+ had the lowest negative likelihood ratio (better rule-out). Authors conclude nMT+ is a more comprehensive major trauma definition than ISS>15 alone. 3