3D-navigation for SI screw fixation - How does it affect radiation exposure for patients and medical personnel?

Background: 3D-navigation for percutaneous sacroiliac (SI) screw fixation is becoming increasingly common and several studies report great advantages of this technology. However, there is still limited clinical evidence on the efficacy regarding radiation exposure for patient and personnel.

Methods: This is a retrospective, single-center cohort study.

Traumatic brain injury in the elderly after a skiing accident: A retrospective cohort study in a level 1 emergency department in Switzerland.

Background: Skiing is a very popular sport worldwide, with increasing trends over the past decades. This study aimed to evaluate the importance of traumatic brain injury (TBI), especially in the elderly, after a ski accident, and to describe its short-term repercussions.

Methodology: Patients were analyzed who were admitted to our neurotrauma center from 2012-2018 after a head trauma while skiing.

Cobalt intoxication: mitochondrial features and condition.

Cobalt intoxication is a rare complication of joint arthroplasty with a metal-on-metal prothesis or metal implants after broken ceramic implants. Patients with metal components should be monitored closely for complications. The awareness for the wide range of clinical pictures of this cobalt intoxication should be increased.

Demographic changes in pelvic fracture patterns at a Swiss academic trauma center from 2007 to 2017.

Background: Increasing life expectancy has led to higher incidence of fragility fractures of the pelvis. These demographic changes may have a direct impact on fracture patterns. The goal of this study was (1) to evaluate demographical trends in patients with pelvic ring injuries at a tertiary Swiss trauma center and (2) to analyze the influence on fracture patterns.

Inter-hospital transfer of polytrauma and severe traumatic brain injury patients: Retrospective nationwide cohort study using data from the Swiss Trauma Register.

Introduction: Polytrauma and traumatic brain injury (TBI) patients are among the most vulnerable patients in trauma care and exhibit increased morbidity and mortality. Timely care is essential for their outcome. Severe TBI with initially high scores on the Glasgow Coma (GCS) scores is difficult to recognise on scene and referral to a Major Trauma Center (MTC) might be delayed.

Indications and interventions of damage control orthopedic surgeries: an expert opinion survey.

Objectives: The objectives of this study were to gather an expert opinion survey and to evaluate the suitability of summarized indications and interventions for DCO.

Background: The indications to perform temporary surgery in musculoskeletal injuries may vary during the hospitalization and have not been defined. We performed a literature review and an expert opinion survey about the indications for damage control orthopaedics (DCO).

Snow avalanche deaths in Switzerland from 1995 to 2014-Results of a nation-wide linkage study.

Objectives: More than 20 people die each year in snow avalanches in Switzerland. Previous studies have primarily described these victims, but were not population based. We investigated sociodemographic factors for avalanche mortality between 1995 and 2014 in the entire Swiss resident population.

Comparison of the Incidence and Severity of Traumatic Brain Injury Caused by Electrical Bicycle and Bicycle Accidents-A Retrospective Cohort Study From a Swiss Level I Trauma Center.

Background: Electrical bicycles (E-bikes) allow people of all ages to ride at high speeds but have an inherent risk of traumatic brain injury (TBI). Their sales have increased tremendously in recent years.

Methods: We performed a retrospective cohort study to compare the incidence and severity of TBI in E-bikers and conventional bicyclists.

The dead and the dying - a difficult part of EMS transport: A Swiss cross-sectional study.

Objective: Most deaths occur in the pre-hospital setting, whereas mortality in the emergency department (ED) is low (<1%). However, our clinical impression is that some patients are being transported to hospital in devastating conditions with no likelihood of survival, but demanding extensive hospital resources. The decision on whether to transport a dying person to hospital or not is a difficult task for emergency medical services (EMS) personnel.

Repatriations and 28-day mortality of ill and injured travellers: 12 years of experience in a Swiss emergency department.

Questions Under Study: Many persons are travelling all over the world; the elderly with pre-existing diseases also travel to places with less developed health systems. Reportedly, fewer than 0.5% of all travellers need repatriation.

Cohort Study on the Association Between Helmet Use and Traumatic Brain Injury in Snowboarders From a Swiss Tertiary Trauma Center.

Background: Since the introduction of helmets in winter sports there is on-going debate on whether they decrease traumatic brain injuries (TBI).

Methods: This cohort study included 117 adult (≥ 16 years) snowboarders with TBI admitted to a level I alpine trauma center in Switzerland between 2000/2001 and 2010/2011. The primary objective was to examine the association between helmet use and moderate-to-severe TBI.

Validation and reclassification of MGAP and GAP in hospital settings using data from the Trauma Audit and Research Network.

Background: Recently, two simple clinical scores were published to predict survival in trauma patients. Both scores may successfully guide major trauma triage, but neither has been independently validated in a hospital setting.

Methods: This is a cohort study with 30-day mortality as the primary outcome to validate two new trauma scores-Mechanism, Glasgow Coma Scale (GCS), Age, and Pressure (MGAP) score and GCS, Age and Pressure (GAP) score-using data from the UK Trauma Audit and Research Network.

Association between head injury and helmet use in alpine skiers: cohort study from a Swiss level 1 trauma center.

The association between helmet use during alpine skiing and incidence and severity of head injuries was analyzed. All patients admitted to a level 1 trauma center for traumatic brain injuries (TBIs) sustained from skiing accidents during the seasons 2000-2001 and 2010-2011 were eligible. Primary outcome was the association between helmet use and severity of TBI measured by Glasgow Coma Scale (GCS), computed tomography (CT) results, and necessity of neurosurgical intervention.

First results from a Swiss level I trauma centre participating in the UK Trauma Audit and Research Network (TARN): prospective cohort study.

Questions Under Study: Patient characteristics and risk factors for death of Swiss trauma patients in the Trauma Audit and Research Network (TARN).

Methods: Descriptive analysis of trauma patients (≥16 years) admitted to a level I trauma centre in Switzerland (September 1, 2009 to August 31, 2010) and entered into TARN. Multivariable logistic regression analysis was used to identify predictors of 30-day mortality.

The association between admission systolic blood pressure and mortality in significant traumatic brain injury: a multi-centre cohort study.

Introduction: Low systolic blood pressure (SBP) is an important secondary insult following traumatic brain injury (TBI), but its exact relationship with outcome is not well characterised. Although a SBP of <90 mmHg represents the threshold for hypotension in consensus TBI treatment guidelines, recent studies suggest redefining hypotension at higher levels. This study therefore aimed to fully characterise the association between admission SBP and mortality to further inform resuscitation endpoints.

A 13-year analysis from Switzerland of non-fatal sledging (sledding or tobogganing) injuries.

Introduction: Winter sports have evolved from an upper class activity to a mass industry. Especially sledging regained popularity at the start of this century, with more and more winter sports resorts offering sledge runs. This study investigated the rates of sledging injuries over the last 13 years and analysed injury patterns specific for certain age groups, enabling us to make suggestions for preventive measures.

Accuracy of prehospital diagnosis and triage of a Swiss helicopter emergency medical service.

Background: Helicopter emergency medical services (HEMSs) have become a standard element of modern prehospital emergency medicine. This study determines the percentage of injured HEMS patients whose injuries were correctly recognized by HEMS physicians.

Methods: A retrospective level III evidence prognostic study using data from the largest Swiss HEMS, REGA (Rettungsflugwacht/Guarde Aérienne), on adult patients with trauma transported to a Level I trauma center (January 2006-December 2007).

Epidemiology and predictors of cervical spine injury in adult major trauma patients: a multicenter cohort study.

Background: Patients with cervical spine injuries are a high-risk group, with the highest reported early mortality rate in spinal trauma.

Methods: This cohort study investigated predictors for cervical spine injury in adult (≥ 16 years) major trauma patients using prospectively collected data of the Trauma Audit and Research Network from 1988 to 2009. Univariate and multivariate logistic regression analyses were used to determine predictors for cervical fractures/dislocations or cord injury.

A pilot case-control study of behavioral aspects and risk factors in Swiss climbers.

Background: Climbing is a popular sport in Switzerland, with approximately 100 000 active participants. There is an inherent risk of falls, overuse and stress-related trauma, with a reported injury rate of 4.2 injuries per 1000 climbing hours.

Systolic blood pressure below 110 mmHg is associated with increased mortality in penetrating major trauma patients: Multicentre cohort study.

Introduction: Non-invasive systolic blood pressure (SBP) measurement is a commonly used triaging tool for trauma patients. A SBP of <90mmHg has represented the threshold for hypotension for many years, but recent studies have suggested redefining hypotension at lower levels. We therefore examined the association between SBP and mortality in penetrating trauma patients.

Do alpine skiers and snowboarders wear protective equipment more often after an accident?

Questions Under Study/principles: Analysis of changes in the behaviour of wearing protective equipment by alpine skiers and snowboarders after injury, performed at a level I trauma centre in Switzerland.

Methods: We present a study, using a standardised questionnaire, assessing behaviour on ski slopes by adult patients admitted between Oct 2007 and April 2008. Patients were re-interviewed after the 2008/2009 season.

Spinal and pelvic injuries in airborne sports: a retrospective analysis from a major Swiss trauma centre.

Background: Adrenalin-seeking airborne sports like BASE-jumping, paragliding, parachuting, delta-gliding, speedflying, and skysurfing are now firmly with us as outdoor lifestyle activities and are associated with a high frequency of severe injuries, especially to the spine.

Methods: Retrospective analysis of all airborne sports-associated spinal and pelvic injuries admitted to a Level I trauma centre in the Swiss Alps between 1st March 2000 and 31st October 2009. Spinal injuries were classified by the Magerl system and pelvic injuries by the AO/OTA scheme modified by Isler and Ganz.

Epidemiology and predictors of spinal injury in adult major trauma patients: European cohort study.

This is a European cohort study on predictors of spinal injury in adult (≥16 years) major trauma patients, using prospectively collected data of the Trauma Audit and Research Network from 1988 to 2009. Predictors for spinal fractures/dislocations or spinal cord injury were determined using univariate and multivariate logistic regression analysis. 250,584 patients were analysed.