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This month’s update is by Leicester’s Emergency Medicine Academic Group. We used a multimodal search strategy, drawing on free open-access medical education resources and literature searches. We identified the five most interesting and relevant papers (decided by consensus) and highlight the main findings, key limitations and clinical bottom line for each paper.
The papers are ranked as:
Worth a peek—interesting, but not yet ready for prime time.
Head turner—new concepts.
Game changer—this paper could/should change practice.
Socioeconomic status is associated with mechanism and intent of injury in patients presenting to a UK Major Trauma Centre by Snell et al
Topic: trauma
Outcome rating: worth a peek
Understanding relationships between socioeconomic status (SES) and major trauma is important to develop effective injury prevention strategies. This study investigated for such association using retrospective analysis of 5 years’ Trauma and Audit Research Network (TARN) data (2014–2019, n=7666) for adults admitted to a UK major trauma centre.1
The researchers used postcodes to link individuals’ TARN-derived trauma mechanism and intent to their Index of Multiple Deprivation (a measure of SES) in quintiles.
Overall, patients were more likely to be from the three lowest SES groups. Compared with the highest SES group, patients were more likely to be from the lowest SES group for stabbings (OR 5.18), self-harm (OR 2.94) or vehicle incidents (OR 1.43). The only mechanism less common in the lowest SES group was sporting injuries (OR 0.6). There was no association between falls ≤2 m (the most common mechanism of injury) and SES.
Further work is required to explore these associations in children, people with short admissions (who are excluded from TARN) and people attending non-major trauma centre hospitals. There may be some SES variation within the level of geographical zones studied.
Bottom line
Major trauma caused by violence, vehicles and self-harm was associated with lower SES.
Derivation and Validation of a Brief Emergency Department-Based Prediction Tool for Posttraumatic Stress After Motor Vehicle Collision by Jones et al
Topic: trauma
Outcome rating: head turner
Most people who attend the ED after significant road …
Footnotes
Twitter @NLeanage, @damian_roland, @TJCoats, @clifford0584
Contributors JDvO conducted the literature searches. JDvO, CP, NL, HT, SK, DR, TJC and TAGS selected papers and drafted the summaries.
Funding This study was supported by the National Institute for Health Research (JDvO receives salary funding from Doctoral Research Fellowship 300901).
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.