Trauma Surgery

New persistent opioid use (NPOU) after surgery occurs in ~7% of opioid‑naïve US adults.

In 43 observational U.S. studies (n=6,507,173) pooled incidence of new persistent opioid use was 7.15% (95% CI 6.02–8.38). Heterogeneity was extreme (I2=100%) and estimates rose when NPOU was defined by opioid use in the 90–180 day postoperative window. Rates differed by definition more than by surgery type, payer, or basic demographics in metaregression. The authors recommend system-level opioid‑sparing strategies because millions of surgical patients may be at population risk. 1

ICU nurses’ pressure‑injury prevention is driven by capability, opportunity, and motivation.

This qualitative meta‑synthesis synthesized 12 studies into 52 findings and 13 categories shaping ICU nurses' prevention behaviors. Prevention practices depend on knowledge, skills, environmental resources, beliefs, and motivation interacting together. The authors advocate coordinated, multi‑component interventions to improve competencies and organizational resources. Interventions should target training, staffing and equipment availability while supporting sustained nurse motivation. 2

SIM‑AKI: externally validated severity index predicts postoperative overall and critical AKI.

SIM‑AKI was developed from 191,938 non‑cardiac surgery patients and validated across three external cohorts (n=118,047; 86,092; 3,727). For overall AKI the C‑statistic was 0.801 in development and 0.754, 0.742, 0.759 in validations, showing good discrimination. For critical AKI C‑statistics were 0.838 and 0.796, 0.805, 0.767 in validations, with good calibration and decision‑curve benefit. The model uses routine perioperative variables and should be prospectively validated locally before operational use. 3