Acute mesenteric ischaemia (AMI) is a life-threatening emergency with in-hospital mortality of 49–64
Traumatic hemorrhagic shock is associated with high mortality. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) has emerged as a temporary hemorrhage control technique; however, its clinical outcomes and complication profile remain inadequately defined. We aimed to conduct a meta-analysis to evaluate the efficacy and safety of REBOA in patients with traumatic hemorrhagic shock. A systematic search of MEDLINE (via PubMed), EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) was conducted up to August 14, 2025. All studies comparing the use of REBOA versus no-REBOA or versus resuscitative thoracotomy (RT) were included. The included studies comprised randomized controlled trials (RCTs) and propensity score-matched (PSM) studies. Study quality was assessed using the Cochrane Risk of Bias tool 2.0 (RoB 2.0) for the included randomized controlled trial and the ROBINS-I tool for non-randomized studies. The primary outcomes were mortality, including in-hospital mortality, 24-hour mortality, and emergency department (ED) mortality. Secondary outcomes comprised complications such as acute kidney injury (AKI), acute respiratory distress syndrome (ARDS), and deep vein thrombosis (DVT). A total of 12 studies involving 7,269 patients were included. Compared with no-REBOA, REBOA was associated with higher in-hospital mortality, increased ED mortality, and a greater incidence of AKI. When compared to RT, REBOA was associated with lower in-hospital mortality. No statistically significant differences were observed between the REBOA group and control groups in other outcome measures. In patients with traumatic hemorrhagic shock, the use of REBOA may be associated with harmful effects due to its significant physiological burden, necessitating careful evaluation of its applicability in clinical practice. Although REBOA appeared to demonstrate a survival advantage over RT, this finding should be interpreted with caution given that RT is typically reserved for patients in extremis or cardiac arrest.
Clinical registries are essential infrastructure for quality improvement, benchmarking, surveillance, comparative effectiveness research, and registry-based trials. Their scientific value, however, depends on whether the data are complete, accurate, standardized, auditable, and fit for the intended use. We present the Eight Cs of data management for clinical registries as a practical lifecycle framework for producing high-quality, analyzable, and comparable data. We developed the framework inductively through reflective analysis of more than two decades of work with seven clinical databases and registries. After the framework was formulated, a targeted narrative review was used to compare it with registry guidance and data-quality standards; no systematic review or formal consensus process was undertaken. The Eight Cs are Collect, Computer entry, Complete, Correct, Code, Clean, Close, and Compute compare. Together, they define a sequential but iterative workflow. The accompanying tables provide implementation controls, monitoring indicators, and a conceptual framework to established guidance. The Eight Cs is an organizing framework rather than a replacement for existing standards. It translates established data-quality principles into a practical lifecycle sequence that can be tested and refined in new and established registries.
To evaluate the association between nighttime emergency department (ED) presentation and postoperative outcomes following emergency colorectal resection. Patients who underwent emergency colorectal resection within 24 h of ED presentation at a regional emergency medical center between June 2009 and February 2023 were retrospectively reviewed. Patients were categorized according to ED presentation time as daytime (08:00–18:00) or nighttime (18:00–08:00). The primary outcome was 30-day mortality. Multivariable logistic regression, propensity score matching (PSM), and inverse probability of treatment weighting (IPTW) analyses were performed. A total of 279 patients were included (159 daytime and 120 nighttime presentations). Thirty-day mortality was significantly higher in the nighttime group than in the daytime group (20.0
Emergency general surgery conditions result in disproportionately high rates of morbidity and mortality. Despite this, little is known about the resources available for related care in Canadian hospitals. Our aim was to describe the resources and structures dedicated to emergency general surgery in Manitoba, Canada. We developed a survey to examine institutional capabilities in providing emergency general surgical care. The survey was developed over three iterations using a modified Delphi technique and was then reviewed separately by community surgeons to ensure broad applicability. A cross-sectional survey of representatives at each of the fourteen hospitals reported to offer emergency general surgery care in Manitoba was performed in two iterations between March and December 2023. Findings were examined descriptively and stratified between tertiary, urban, and rural centres. Our aim was to describe the resources and structures in place for providing related care, including the proportion of hospitals with a dedicated emergency general surgery care model. After exclusions and non-responses, we examined the resources and capabilities of nine institutions. Two tertiary, two urban community, and five rural community centres were evaluated. Of these institutions, 4/9 (44.4
