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Background and Objectives: Trauma patients' characteristics and prehospital medical systems differ between countries. We aimed to establish a simple field triage scheme for identifying severe injury patients that reflect the regional features of trauma demographics and trauma management systems. Methods: This was a retrospective cohort study using the Japan Trauma Data Bank (JTDB). The main outcome was all‐cause in‐hospital mortality. Blunt trauma patients ≥18 years of age were enrolled. Thirty‐five parameters (including demographic characteristics, mechanism of injury, vital signs, and abbreviated injury scale 98) were assessed for each patient using a machine learning method. After calculating the feature importance of each variable from the JTDB 2019–2021 dataset, we selected variables and made schemes by including different combinations of variables. The schemes were analyzed using a receiver operating characteristic curve and validated using the JTDB 2004–2018 dataset. Results: We analyzed 48,194 subjects in JTDB 2019–2021. Eight variables were selected and schemes calculated and evaluated using 185,728 cases in the JTDB 2004–2018 dataset. The area under the curve of the most accurate and simplest scheme was 0.845. When the cut‐off value was set at 6, the mortality rate of the positive group (i.e., score ≥6) was 31.8%, the undertriage rate was 4.6%, and the overtriage rate was 68.2%. Conclusions: We established an easy and reliable field triage scheme suited to the Japanese trauma system which comprised disturbance of consciousness, respiratory failure, shock, head injury, chest injury, multiple injury, fall from height, and age. [ABSTRACT FROM AUTHOR]

Temperature control is the only neuroprotective intervention suggested in current international guidelines for patients with return of spontaneous circulation after cardiac arrest, but the prevalence of temperature control therapy, temperature settings, and outcomes have not been clearly reported. We aimed to investigate changes over 7 years in provision of temperature control treatment among out-of-hospital cardiac arrest (OHCA) patients in Kanto region, Japan. Data of all adult OHCA patients who survived for more than 24 hours in the prospective cohort studies, SOS-KANTO 2012 (conducted from 2012 to 2013) and SOS-KANTO 2017 (conducted from 2019 to 2021), in Japan were included. We compared the prevalence of temperature control and the proportion of mild (≥35°C) and moderate (from 32°C to 34.9°C) hypothermia between the two study groups. We also performed a Cox regression analysis to evaluate 30-day mortality adjusted by temperature control therapy (none, moderate hypothermia, or mild hypothermia), age, sex, past medical history, witnessed status, bystander cardiopulmonary resuscitation, initial rhythm, location of arrest, and dataset (SOS-KANTO 2012 or 2017). We analyzed data from 2936 patients ( n  = 1710, SOS-KANTO 2012; n  = 1226, SOS-KANTO 2017). Use of temperature control was lower (45.3% vs. 41.4%, p  = 0.04), moderate hypothermia was lower ( p  < 0.01), and mild hypothermia was higher ( p  < 0.01) in SOS-KANTO 2017 compared with SOS-KANTO 2012. The survival rate was significantly higher for patients with mild ( p  < 0.01) and moderate ( p  < 0.01) hypothermia compared with those who did not receive temperature control therapy. Overall, the incidence of moderate hypothermia decreased and that of mild hypothermia increased and the use of temperature control decreased between the two studies conducted 7 years apart in the Kanto area, Japan. Temperature control management might improve survival of patients with OHCA.

External iliac artery (EIA) injuries caused by blunt trauma are rare. Here, we describe a blunt EIA injury after a motorbike accident suffered by a 16-year-old male. Despite conservative treatment, intermittent claudication persisted. He was successfully treated by elective endovascular stent-graft implantation on day 59 after the injury. Ankle-brachial index (ABI) improved, as did his symptoms. A contrast-enhanced computed tomography scan on postoperative day 90 showed no residual stenosis and favorable peripheral blood flow. This report suggests that elective endovascular stent-graft implantation might be a viable treatment option for blunt EIA injuries.