Incidence Of Injury Research Articles

Shifting Trends in the Epidemiology of Cervical Spine Injuries: An Analysis of 11,822 Patients from the National Electronic Injury Surveillance System over Two Decades.

Cervical spine injuries (CSIs) are heterogeneous in nature and often lead to long-term disability and morbidity. However, there are few recent and comprehensive epidemiological studies on CSI. The objective of this study was to characterize recent trends in CSI patient demographics, incidence, etiology, and injury level. The National Electronic Injury Surveillance System was used to extract data on CSIs from 2002 to 2022. Weighted national estimates of CSI incidence were computed using yearly population estimates interpolated from U.S. census data. Data analysis involved extracting additional information from patient narratives to categorize injury etiology (i.e., fall) and identify CSI level. K-means clustering was performed on cervical levels to define upper versus lower cervical injuries. Appropriate summary statistics including mean with 95% confidence intervals and frequency were reported for age, sex, race, ethnicity, etiology, and disposition. Age between groups was compared using an independent weighted Z-test. All categorical variables were compared using Pearson chi-squared tests with Bonferroni correction for multiple comparisons. Ordinary least squares linear regression was used to quantify the rate of change of various metrics with time. A total of 11,822 patient records met the study criteria. The mean age of patients was 62.4 ± 22.7 years, 52.4% of whom were male and 61.4% of whom were White, 7.4% were Black, 27.8% were not specified, and the remaining comprised a variety of ethnicities. The most common mechanism of CSI was a fall (67.3%). There was a significant increase in the incidence of cervical injuries between 2003 and 2022 (p < 0.001). Unbiased K-means clustering defined upper cervical injuries as C1-C3 and lower cervical injuries as C4-C7. The mean age of patients with upper CSIs was 72.3 ± 19.6, significantly greater than the age of those with lower CSIs (57.1 ± 23.1, p < 0.001). Compared with lower CSI, White patients were more likely to have an upper CSI (67.4% vs. 73.7%; p < 0.001). While Black/African American (7.5% vs. 3.8%) and Hispanic (2.5% vs. 1.0%) patients were more likely to have a lower CSI (p < 0.001). Our study identified a significant increase in the incidence of CSIs over time, which was associated with increasing patient age. Our study detected a pragmatic demarcation of classifying upper injuries as C1-C3 and lower cervical injuries as C4-C7. Upper injuries were seen more often in older, White females who were treated and admitted, and lower injuries were seen more often in young, Black male patients who were released without admission.

Relationship between indexed surgery and postcardiotomy extracorporeal life support outcomes.

Veno-arterial extracorporeal life support (V-A ECLS) is increasingly being utilized for postcardiotomy shock (PCS), though data describing the relationship between type of indexed operation and outcomes are limited. This study compared V-A ECLS outcomes across four major cardiovascular surgical procedures. This was a single-center retrospective study of patients who required V-A ECLS for PCS between 2015 and 2022. Patients were stratified by the type of indexed operation, which included aortic surgery (AoS), coronary artery bypass grafting (CABG), valve surgery (Valve), and combined CABG and valve surgery (CABG + Valve). Factors associated with postoperative outcomes were assessed using logistic regression. Among 149 PCS patients who received V-A ECLS, there were 35 AoS patients (23.5%), 29 (19.5%) CABG patients, 59 (39.6%) Valve patients, and 26 (17.4%) CABG + Valve patients. Cardiopulmonary bypass times were longest in the AoS group (p < 0.01). Regarding causes of PCS, AoS patients had a greater incidence of ventricular failure, while the CABG group had a higher incidence of ventricular arrhythmia (p = 0.04). Left ventricular venting was most frequently utilized in the Valve group (p = 0.07). In-hospital mortality was worst among CABG + Valve patients (p < 0.01), and the incidence of acute kidney injury was highest in the AoS group (p = 0.03). In multivariable logistic regression, CABG + Valve surgery (odds ratio (OR) 4.20, 95% confidence interval 1.30-13.6, p = 0.02) and lactate level at ECLS initiation (OR, 1.17; 95% CI, 1.06-1.29; p < 0.01) were independently associated with mortality. We demonstrate that indications, management, and outcomes of V-A ECLS for PCS vary by type of indexed cardiovascular surgery.

A prospective study of injuries and illnesses among 910 amateur golfers during one season

ObjectivesOur aims were (a) to describe the prevalence and incidence of self-reported injuries and illnesses of amateur golfers over a 5-month period and (b) to investigate potential risk factors for...

Work-related injuries of rehabilitation therapists and measures for prevention

BackgroundRehabilitation therapists often perform physically demanding treatments that may result in work-related injuries, yet related studies are scarce. This study aimed to investigate the work-related injuries of rehabilitation therapists and provide feasible preventive measures.MethodsA cross-sectional study was carried out in 34 regions across China using an online questionnaire. The survey gathered responses primarily from 1,198 rehabilitative therapists working in 120 health institutes. Following data collection, descriptive analysis, chi-square tests, logistic regression, and receiver operating characteristic (ROC) curves were employed to analyze the data.ResultsIn this study, the incidence of work-related injuries was reported to be 87% (n = 1,041). The top three musculoskeletal issues reported were low back pain (12%), neck pain (10%), and shoulder pain (9%). Logistic regression and ROC curve analysis identified that working as a physiotherapist and years of work experience (OR [95% CI]: 1.03 [0.99–1.07]) were significant contributors to the incidence of work-related injuries. Specifically, neuro-physiotherapists (OR [95% CI]: 3.04 [1.56–5.92]), musculoskeletal physiotherapists (OR [95% CI]: 2.46 [1.16–5.18]), and intensive care physiotherapists (OR [95% CI]: 4.70 [1.24–17.88]) were at higher risk. Furthermore, five factors were proven to be associated with injury prevention as reported by therapists: patient engagement (OR [95% CI]: 0.38 [0.23–0.62]), improving techniques (OR [95% CI]: 0.59 [0.39–0.90]), maintaining exercise habits (OR [95% CI]: 0.59 [0.40–0.86]), utilizing instruments (OR [95% CI]: 0.80 [0.53–1.19]), and strengthening education (OR [95% CI]: 0.43 [0.21–0.90]).ConclusionThe present study investigated the factors contributing to work-related injuries among rehabilitation therapists, with a focus on identifying both risk and preventive measures. These findings offer new perspectives on decreasing injury risk.

Retrospective analysis of nonfatal skeletal injuries sustained in road incidents involving electric scooters

BACKGROUND: Although scooters were officially recognized as vehicles in the Russian Federation not so long ago, the incidence of scooter injuries has been growing for several years. AIM: To analyze epidemiological data and the nature of injuries in victims of nonfatal electric scooter incidents. MATERIALS AND METHODS: The study included 78 medical records of persons injured in road incidents involving electric scooters who were treated in the trauma department of the Regional Hospital No. 4 of Adler between 2020 and 2021. The nature of the injury by sex, age, seasonality, time of day, and characteristics of damage depending on the category of road users (driver and pedestrian) were analyzed retrospectively. RESULTS: Of the 78 road incidents involving electric scooters, 28 occurred in 2020 and 50 in 2021. The sex distribution was nearly the same, with ≥40 men and 38 women, and their median age was 36 (30–45.8) years. Most of the accidents (n=52) occurred in summer and autumn months. The exact time of injury was known in 35 cases (17‰ in the daytime, 18‰ in the evening. Depending on the circumstances, all accidents were divided into falls from electric scooters (n=73), collisions of moving scooters with pedestrians (n=3), and collisions of moving scooters with a moving car (n=2). Of the 73 patients who sustained fractures, 67 had a closed type. Intra-articular fractures were detected in 41 victims. Lowe-limb fractures (n=43) prevailed over fractures of other localizations. In addition, 18 cases of knee injuries and 14 cases of trauma to the proximal tibial epiphysis were recorded. CONCLUSION: The incidence of scooter injury is increasing. In the warm regions of the Russian Federation, such accidents have a year-round prevalence with predominance in the summer months owing to the large influx of vacationers. More often than other incidents, falls from electric scooters are noted, resulting in lower limb injuries, including with intra-articular fractures of the condyles of the tibia.

Systematic review with meta-analysis of intraoperative neuromonitoring during thyroid reoperation

Objective: Recurrent laryngeal nerve (RLN) injury is a serious complication during thyroid reoperation. Intraoperative neuromonitoring (IONM) is one of the means to reduce RLN paralysis. However, the role of IONM during thyroidectomy is still controversial. The aim of this study was to assess whether the IONM could reduce the incidence of RLN injury during thyroid reoperation. Methods: We performed a systematic review to identify studies in English language which were published between January 1, 2004, and March 25, 2023 from PubMed, EMBASE, and Cochrane Library, comparing the use of IONM and Visualization Alone (VA) during thyroid reoperation. The RLN injury rate was calculated in relation to the number of nerves at risk. All data were analyzed using Review Manger (version 5.3) software. The Cochran Q test (I2 test) was used to test for heterogeneity. Odds ratios were estimated by fixed effects model or random effects model, according to the heterogeneity level. Results: Eleven studies (3655 at-risk nerves) met criteria for inclusion. Data presented as odds ratio(OR) and their 95% confidence intervals(CI). Incidence of overall, temporary, and permanent RLN injury in IONM group were, respectively, 4.67%, 4.17%, and 2.39%, whereas for the VA group, they were 8.30%, 6.27%, and 2.88%. The summary OR of overall, temporary, and permanent RLN injury compared using IONM and VA were, respectively, 0.68 (95%CI 0.4-1.14, p=0.14), 0.82 (95%CI 0.39-1.72, p=0.60), and 0.62 (95%CI 0.4-0.96, p=0.03). Conclusions: The presented data showed benefits of reducing permanent RLN injury by using IONM, but without statistical significance for temporary RLN injury. doi: https://doi.org/10.12669/pjms.40.8.8241 How to cite this: Ji S, Hu M, Zhang C, Pei M. Systematic review with meta-analysis of intraoperative neuromonitoring during thyroid reoperation. Pak J Med Sci. 2024;40(8):---------. doi: https://doi.org/10.12669/pjms.40.8.8241 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Effectiveness of a twelve-week manual therapy intervention for shoulder injury prevention and management in female volleyball players

Purpose: This study aimed to assess the efficacy of a twelve-week manual therapy intervention in preventing and managing shoulder injuries among female volleyball players through a randomized controlled trial. Material and Methods: Forty college female volleyball players aged 18-25 years with a history of shoulder pain or dysfunction were recruited and randomly assigned to either a manual therapy intervention group or a control group. The intervention group received a comprehensive manual therapy program, including soft tissue mobilization, joint mobilization, and tailored exercise therapy, administered by a licensed physical therapist. Outcome measures, including shoulder range of motion, strength, pain levels, functional performance, and incidence of shoulder injuries, were assessed at baseline, post-intervention (twelve weeks), and follow-up (three months post-intervention). Statistical analysis was conducted using Paired t-tests and Wilcoxon Signed-Rank Tests. Results: Significant improvements were observed in shoulder range of motion, strength, and functional performance in the intervention group compared to the control group at post-intervention and follow-up assessments. Specifically, the intervention group exhibited notable enhancements in shoulder range of motion and strength. Moreover, a significant reduction in baseline pain levels was observed among participants in the intervention group. Conclusions: The findings suggest that a comprehensive twelve-week manual therapy program holds promise in effectively addressing shoulder injuries among female volleyball players. Manual therapy techniques, including soft tissue and joint mobilization, alongside tailored exercise therapy, may serve as valuable adjuncts to traditional preventive strategies in sports injury management.

Perspectives on reasons why football and handball players sustain acute and severe knee injuries: a mixed-methods concept mapping study

BackgroundThe high incidence of knee injuries in football/handball challenges effective prevention. Identifying tangible and modifiable factors associated with a knee injury may innovate preventive actions. Engaging key stakeholders can reveal...

Fatal and Nonfatal Firearm Injury Rates by Race and Ethnicity in the United States, 2019 to 2020.

Racial disparities in firearm injury death in the United States are well established. Less is known about the magnitude of nonfatal and total firearm injury. To combine health care data with death certificate data to estimate total firearm injuries in various racial and ethnic groups. Retrospective, cross-sectional study. Fatal injury data were collected from the Centers for Disease Control and Prevention. Data on nonfatal injuries were collected from the Nationwide Emergency Department Sample (NEDS), a 20% stratified sample of U.S. emergency department visits, weighted to provide national estimates for the United States, 2019 to 2020. All firearm injuries and deaths in the United States. Race and ethnicity were classified into 5 mutually exclusive categories: Asian or Pacific Islander, Black, Hispanic, Native American, and White. International Classification of Diseases, 10th Revision codes were used to classify firearm injury intent. Incidence of fatal and nonfatal injury in the U.S. population and case-fatality ratios (CFRs). There were 252 376 total firearm injuries, including 84 908 deaths from firearm injures. Of all firearm injuries, 37.8% were unintentional, 37.3% were assault related, 21.0% were self-harm, and 1.3% were law enforcement associated. Self-harm had the highest CFRs (90.9% overall). Unintentional injuries accounted for just 1021 (1.2%) deaths but 94 433 (56.4%) of nonfatal injuries. Rates of self-harm were highest among White persons (11.0 per 100 000 population in 2020) followed by Native Americans (8.6 per 100 000). Rates of assault were highest among Black persons (70.1 per 100 000), as were unintentional injuries (56.1 per 100 000). Findings are limited by the accuracy of discharge coding in NEDS, particularly regarding injury intent and patient race and ethnicity. From 2019 to 2020, the total burden of firearm injuries amounts to an average of 1 injury every 4 minutes and 1 death every 12 minutes in the United States. Racial disparities in firearm injury death are mirrored in nonfatal injury. None.

Sex disparities in cardiac sarcoidosis patients undergoing implantable cardioverter-defibrillator implantation.

In patients with cardiac sarcoidosis (CS), implantable cardioverter-defibrillators (ICDs) are important for preventing sudden cardiac death. This study aimed to investigate sex disparities in CS patients undergoing ICD implantation. The 2016-2020 National Inpatient Sample (NIS) database compared the characteristics and outcomes of males and females with CS receiving ICDs. Among 760 CS patients who underwent inpatient ICD implantation, 66.4% were male. Males were younger (55.0vs. 56.9 years, p<.01), had higher rates of diabetes (31.7%vs. 21.6%, p<.01) and chronic kidney disease (CKD) (16.8%vs. 7.8%, p<.01) but lower prevalence of atrial fibrillation (AF) (11.9%vs. 23.5%, p<.01), sick sinus syndrome (4.0%vs. 7.8%, p=.024), ventricular fibrillation (VF) (9.9%vs. 15.7%, p=.02), and black ancestry (31.9%vs. 58.0%, p<.01). Unadjusted major adverse cardiovascular events (MACE), defined as a composite of in-hospital death, myocardial infarction (MI), and ischemic stroke, was higher in females (11.8%vs. 6.9%, p=.024), but when adjusted for age and tCharlson Comorbidity Index (CCI), females demonstrated significantly lower odds of experiencing MACE (aOR: 0.048, 95% CI: 0.006-0.395, p=.005). Incidence of acute kidney injury (AKI) post-ICD was significantly lower in females (15.7%vs. 23.8%, p=.01) as was the adjusted odds (aOR: 0.282, 95% CI: 0.146-0.546, p<.01). There was comparable mean length of stay and hospital charges. ICD utilization in CS patients is more common among males, who have a higher prevalence of diabetes and CKD but a lower prevalence of AF, sick sinus syndrome, and VF. Adjusted MACE and AKI were significantly lower in females.

Beyond the Valve: Incidence, Outcomes, and Modifiable Factors of Acute Kidney Injury in Patients with Infective Endocarditis Undergoing Valve Surgery—A Retrospective, Single-Center Study

Background/Objectives: Infective endocarditis (IE) often requires surgical intervention, with postoperative acute kidney injury (AKI), posing a significant concern. This retrospective study aimed to investigate AKI incidence, its impact on short-term mortality, and identify modifiable factors in patients with IE scheduled for valve surgery. Methods: This single-center study enrolled 130 consecutive IE patients from 2013 to 2021 undergoing valve surgery. The creatinine levels were monitored pre- and postoperatively, and AKI was defined by Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Patient demographics, comorbidities, procedural details, and complications were recorded. Primary outcomes included AKI incidence; the relevance of creatinine levels for AKI detection; and the association of AKI with 30-, 60-, and 180-day mortality. Modifiable factors contributing to AKI were explored as secondary outcomes. Results: Postoperatively, 35.4% developed AKI. The highest creatinine elevation occurred on the second postoperative day. Best predictive value for AKI was a creatinine level of 1.35 mg/dL on the second day (AUC: 0.901; sensitivity: 0.89, specificity: 0.79). Elevated creatinine levels on the second day were robust predictors for short-term mortality at 30, 60, and 180 days postoperatively (AUC ranging from 0.708 to 0.789). CK-MB levels at 24 h postoperatively and minimum hemoglobin during surgery were identified as independent predictors for AKI in logistic regression. Conclusions: This study highlights the crucial role of creatinine levels in predicting short-term mortality in surgical IE patients. A specific threshold (1.35 mg/dL) provides a practical marker for risk stratification, offering insights for refining perioperative strategies and optimizing outcomes in this challenging patient population.

Incidence of obstetric anal sphincter injuries according to the type of forceps used in the Mexican population.

This study describes the frequency of obstetric anal sphincter injuries (OASIS) in patients after instrumental delivery according to the type of forceps used. A retrospective comparative cohort study was conducted on patients who underwent instrumental delivery from January 2017 to April 2022. The primary outcome was the presence of OASIS following delivery. Patients were categorized into Cohort A if only rotation forceps were used, Cohort B for only traction forceps, and Cohort C if both types were used sequentially. Statistical analysis was performed with SPSS (IBM, New York, NY) with χ2, Fisher's exact, and analysis of variance testing. A P-value <0.05 was considered significant. OASIS occurred in 45 of 328 instrumental deliveries. OASIS after rotation forceps occurred in 12.9% (n = 8) of cases, after traction forceps in 13.2% (n = 34), and after sequential use of rotation and traction forceps in 37.5% (n = 3) of cases (p = 0.141). An odds ratio (OR) of 0.91 (95% confidence interval [CI] 0.40-2.08) for OASIS was obtained with the use of rotation forceps, 0.81 (95% CI 0.38-1.70) for traction forceps, and 3.97 (95% CI 0.91-17.2) for the sequential use of rotation and traction forceps. There were no significant differences in the presence of OASIS comparing traction and rotation forceps. A non-significant trend of higher OASIS following the sequential use of traction and rotation forceps was observed.

Extracranial Complications in Monitored and Non-Monitored Patients with Traumatic Brain Injury in the BEST TRIP Trial and a Companion Observational Cohort.

Extracranial complications occur commonly in patients with traumatic brain injury (TBI) and can have implications for patient outcome. Patient-specific risk factors for developing these complications are not well studied, particularly in low and middle-income countries (LMIC). The study objective was to determine patient-specific risk factors for development of extracranial complications in TBI. We assessed the relationship between patient demographic and injury factors and incidence of extracranial complications using data collected September 2008-October 2011 from the BEST TRIP trial, a randomized controlled trial assessing TBI management protocolized on intracranial pressure (ICP) monitoring versus imaging and clinical exam, and a companion observational patient cohort. Extracranial infections (55%), respiratory complications (19%), hyponatremia (27%), hypernatremia (27%), hospital acquired pressure ulcers (6%), coagulopathy (9%), cardiac arrest (10%), and shock (5%) occurred at a rate of ≥5% in our study population; overall combined rate of these complications was 82.3%. Tracheostomy in the intensive care unit (p<0.001), tracheostomy timing (p=0.025), mannitol and hypertonic saline doses (p<0.001), brain-specific therapy days and brain-specific therapy intensity (p<0.001), extracranial surgery (p<0.001), and neuroworsening with pupil asymmetry (p=0.038) were all significantly related to the development of one of these complications by univariable analysis. Multivariable analysis revealed ICP monitor use and brain-specific therapy intensity to be the most common factors associated with individual complications. Extracranial complications are common following TBI. ICP monitoring and treatment are related to extra-cranial complications. This supports the need for reassessing the risk-benefit balance of our current management approaches in the interest of improving outcome.

Cysteine as an Innovative Biomarker for Kidney Injury.

Kidney transplantation is a widely used treatment for end-stage kidney disease. Nevertheless, the incidence of acute kidney injury (AKI) in deceased donors poses a potential hazard because it significantly increases the risk of delayed graft function and potentially exerts an influence on the kidney allograft outcome. It is crucial to develop a diagnostic model capable of assessing the existence and severity of AKI in renal grafts. However, no suitable kidney injury markers have been developed thus far. We evaluated the efficacy of the molecular probe NPO-B, which selectively responds to cysteine, as a new diagnostic tool for kidney injury. We used an in vitro model using ischemia/reperfusion injury human kidney-2 cells and an in vivo ischemia/reperfusion injury mouse model. Additionally, cysteine was investigated using urine samples from deceased donors and living donors to assess the applicability of detection techniques to humans. This study confirmed that the NPO-B probe effectively identified and visualized the severity of kidney injury by detecting cysteine in both in vitro and in vivo models. We observed that the fluorescence intensity of urine samples measured using NPO-B from the deceased donors who are at a high risk of renal injury was significantly stronger than that of the living donors. If implemented in clinical practice, this new diagnostic tool using NPO-B can potentially enhance the success rate of kidney transplantation by accurately determining the extent of AKI in renal grafts.

Meta-analysis reveals higher intraoperative urologic complication rates in minimally invasive radical hysterectomy compared to abdominal radical hysterectomy.

Minimally invasive radical hysterectomy (MIRH) has been increasingly adopted for its benefits of reduced blood loss and shorter hospital stays. This study aims to conduct a meta-analysis to compare the incidence of intraoperative urologic complications, including bladder and ureteral injuries, between MIRH and abdominal radical hysterectomy (ARH). We systematically searched PubMed, EMBASE, and the Cochrane Library for studies published up to April 2024. A total of 35 studies were analyzed to compute odds ratios (ORs) for intraoperative urologic complications, bladder injuries, and ureteral injuries, focusing on subgroup evaluations by publication year, study quality, body mass index (BMI), geographic region, and surgical method. The meta-analysis demonstrates that MIRH is associated with higher risks of intraoperative urologic complications (OR=2.412, 95% CI: 1.995-2.916, P<0.001), bladder injuries (OR=2.109, 95% CI: 1.567-2.839, P<0.01), and ureteral injuries (OR=2.549, 95% CI: 1.992-3.262, P<0.001). No publication bias was detected across the studies, ensuring the robustness of the findings. Significant differences in complication rates were also observed across geographic and procedural subgroups. The findings confirm that MIRH has a higher rate of intraoperative urologic complications, including bladder and ureteral injuries, compared to ARH. These results provide essential insights that could guide clinical decision-making and influence surgical practice guidelines.

Incidence, clinical classification and risk factors of cyclosporin A-induced liver injury in allogeneic haematopoietic stem cell transplant recipients.

There is limited real-world data on cyclosporin A (CsA)-induced liver injury (CILI). This study aims to investigate the incidence, clinical classification and risk factors of CILI, thereby providing evidence to inform the treatment of CILI. Inpatients receiving haematopoietic stem cell transplantation (HSCT) and treated with CsA were included. Patient information was collected to assess suspicious CILI by the Roussel Uclaf causality assessment method (RUCAM) scale. We evaluated the pattern and severity of CILI. The independent risk factors of CILI were identified by multivariable logistic regression. A total of 216 allogeneic HSCT (allo-HSCT) recipients were included in this study. The incidence of CILI was 15.3% (95% confidence interval [CI]: 10.4%-20.1%). Among these cases, 84.8% displayed a hepatocellular pattern, and 90.9% of CILI was of mild severity. Baseline alanine aminotransferase (ALT) level (OR = 1.030, 95% CI: 1.008-1.053, P = .008) and trough concentration level of CsA (OR = 1.007, 95% CI: 1.002-1.012, P = .009) were identified as independent risk factors for CILI. The incidence of CILI in allo-HSCT recipients is notably high. Recipients with elevated baseline ALT levels and higher exposure to CsA are more susceptible to developing CILI.

Study on needle stick injuries during surgery and blunt needle use for reducing occupational exposure and hygiene benefits.

The conventional round suture needle poses a significant risk of needle stick injuries among surgical physicians, identified as a global occupational hazard by the World Health Organization, increasing hospital costs and exposure to bloodborne pathogens. While novel blunt suture needles have shown promise in reducing these risks, their adoption is limited domestically, prompting a study to compare their efficacy against traditional sharp needles in reducing needle stick injuries among surgical physicians. To investigate suture needle stick injuries among surgical doctors during operations and assess the application effectiveness of a novel blunt suture needle. A total of 106 surgical department physicians from March 2021 to February 2023 participated in the study. After completing a questionnaire survey on suture needle injuries during surgery, the participants were divided into two groups. Over a 6-month intervention period, the control group used regular round needles while the study group utilized novel blunt suture needles. Subsequently, suture needle injury incidence rates and economic hygiene benefits were compared between the two groups. The suture needle injury questionnaire survey showed that over the past 6 months, among 106 surgical department physicians, 20 needle stick injuries occurred, yielding an incidence rate of 18.87%. The highest incidence (65.00%) was during suturing incisions longer than 10 cm, primarily when visibility was poor (70.00%). Surgeons linked most injuries (60.00%) to prolonged surgical duration causing fatigue. Although 85.00% detected injuries within 1 minute, only 40.00% were reported, often due to perceived reporting complexity. Following intervention, the study group had significantly fewer injuries per surgery and lower occupational exposure costs compared to the control group (p< 0.05). Surgical department physicians commonly sustain suture needle injuries while suturing incisions of 5-10 cm length under poor visibility, exacerbated by prolonged surgical duration. Despite detecting most injuries within 1 minute, only 40% are reported. The implementation of novel blunt suture needles significantly decreases injury rates, resulting in reduced occupational exposure costs and favorable safety and economic hygiene outcomes.

The prognosis of iatrogenic saphenous nerve injuries during hamstring tendon harvesting in anterior cruciate ligament reconstruction

PurposeThis study aims to evaluate the long-term outcomes of saphenous nerve (SN) injuries from hamstring tendon harvesting during ACL reconstruction, focusing on clinical results and patient satisfaction after at least two years. Additionally, it investigates the incidence, recovery patterns, and impact of these injuries on functional outcomes, daily activities, and ACL re-rupture rates immediately post-surgery and at final follow-up.Materials and methodsA retrospective review was conducted on patients who had undergone ACL reconstruction with hamstring tendon grafts at a single institution between January 2015 and January 2020. The incidence of SN injuries was assessed immediately after surgery and at final follow-up. Additionally, the recovery rate and time were evaluated, and the impact of these injuries on functional outcomes was measured using the Lysholm Knee Score (LKS) and patient-reported effects on daily activities.ResultsOf the 159 patients analyzed, iatrogenic SN injuries were initially observed in 87 (54.7%) patients post-ACLR. By the final follow-up, paresthesia had resolved in 36 (22.6%) patients within an average of 11.1 months. Persistent SN injuries were recorded in 51 (32.1%) patients, affecting various extents of the infrapatellar branch (IPBSN) and the sartorial branch (SBSN) of the saphenous nerve. Patients with persistent SN injuries experienced a significant impact on daily activities and had lower LKS scores compared to those without injuries or with recovered injuries. Furthermore, a higher re-rupture rate was associated with persistent SN injuries.ConclusionsThe study finds that SN injuries during hamstring graft harvesting for ACL reconstruction are common, with a significant portion of patients experiencing persistent sensory deficits for at least two years postoperatively. These injuries are observed to adversely affect patient satisfaction and functional outcomes and to increase the re-rupture rate.

Acute kidney injury with intravenous colistin sulfate compared with polymyxin B in critically ill patients: A real-world, retrospective cohort study.

Polymyxins have re-emerged as a last-resort therapeutic option for infections caused by carbapenem-resistant gram-negative bacteria. Nephrotoxicity induced by polymyxins is a significant limitation of its use in the clinic. Polymyxin B and colistin sulfate are two widely used active formulations of polymyxins. However, there is a lack of studies conducting a comparative assessment of nephrotoxicity between the two formulations. This study aimed to compare the nephrotoxicity of polymyxin B and colistin sulfate in critically ill patients. We conducted a retrospective cohort study among critically ill patients who received intravenous polymyxin B or colistin sulfate for over 48 h from January 2017 to January 2024. The primary outcome was the incidence of acute kidney injury (AKI) associated with polymyxins, and the secondary outcome was 30-day all-cause mortality. Additionally, the risk factors of polymyxins-induced AKI and 30-day all-cause mortality were identified by Cox proportional hazard regression analysis. A total of 473 patients were included in this study. The overall incidence of AKI was significantly higher in patients who received polymyxin B compared to those who received colistin sulfate in the unmatched cohort (20.8% vs. 9.0%, p = 0.002) and in the propensity score matching cohort (21.1% vs. 7.0%, p = 0.004), respectively. However, there was no significant difference in 30-day all-cause mortality between the two groups. Polymyxin type, septic shock, and concomitant use of vasopressors were identified as independent risk factors for polymyxin-induced AKI. The prevalence of AKI was higher among patients who received polymyxin B compared to those treated with colistin sulfate. However, there was no significant difference in 30-day all-cause mortality between the two groups. Further prospective, multicenter studies with larger sample sizes are needed to validate these findings.

Incidence of Acute Kidney Injury Post Transcatheter Aortic Valve Implantation (TAVI): A Single-Center Experience

Incidence of Acute Kidney Injury Post Transcatheter Aortic Valve Implantation (TAVI): A Single-Center Experience