Trauma Surgery

Index injury type predicts long-term violent reinjury risk.

In a multicenter cohort of 29,810 patients with violent injuries, 13.4% experienced recurrent violent injury over follow-up. Seven-year reinjury probability was highest after index stabbing (19.5%) and blunt assault (17.4%), lower after firearm injury (12.6%). Patients with blunt assault were most likely to experience blunt reinjury, suggesting mechanism-specific recurrence patterns. Findings apply to adults and children presenting to level I trauma centers and support mechanism-tailored prevention efforts. 1

Non-technical errors present in two-thirds of EGS deaths, mostly outside theatre.

In a national retrospective cohort of emergency general surgery mortalities, non-technical errors (NTEs) occurred in 67.9% (790/1164) of deaths. Reviewers identified 1,053 unique NTEs; situational awareness (49.3%) and decision-making errors (40.9%) were most common. Nearly 90% of NTEs occurred outside the operating theatre, implicating surgical and non-surgical teams. NTS improvement strategies must extend beyond the theatre and focus on recurrent behaviors like missed diagnosis and delayed intervention. 2

Simplified binary combat triage: high sensitivity for major trauma but high overtriage.

Among 4,522 military casualties, a judgment-based binary triage produced undertriage 3.6% for ISS≥16 and sensitivity 96.4% for major trauma. Undertriage for AIS≥3 was 8.5% with sensitivity 91.5%, indicating good detection of severe injuries. Overtriage was substantial at 62.7%, reflecting a deliberate sensitivity-over-specificity trade-off in combat care. Severe head and thoracic injuries accounted for many undertriaged major traumas, pointing to limits of simple judgment-based assessments. 3