Background/Objectives: The Geriatric Trauma Outcome Score (GTOS) is used to predict in-hospital mortality in geriatric patients with trauma. However, its applicability to elderly patients with multiple traumas and severe traumatic brain injury (TBI) remains poorly understood. This study aimed to evaluate the predictive accuracy of the GTOS in elderly patients with multiple traumas and TBI and assess its performance in patients with mild and severe TBI. Methods: We retrospectively analyzed 1283 geriatric multiple trauma patients (aged ≥ 65 years) treated at a regional trauma center from 2019 to 2023. Patients were stratified into mild (head Abbreviated Injury Scale [AIS] ≤ 3) and severe (head AIS ≥ 4) TBI groups. GTOS values were calculated for each patient, and predicted mortality was compared with in-hospital mortality. GTOS predictive accuracy was assessed by analyzing the receiver operating characteristic curve. Results: Patients had a median Injury Severity Score of 18 (interquartile range: 10–25); 33.3% of patients received red blood cell transfusions within 24 h. The overall in-hospital mortality rate was 17.9%; GTOS predicted a mortality rate of 17.6% ± 0.17. The GTOS accurately predicted the in-hospital mortality in the entire cohort, achieving an Area Under the Curve (AUC) of 0.798. Predictive accuracy diminished for patients with severe TBI (AUC = 0.657), underestimating actual mortality (39.5% vs. 28.8% predicted). Conclusions: While the GTOS remains a useful tool for predicting in-hospital mortality in elderly patients with multiple traumas, it consistently underestimates mortality risk in those with severe TBI. Therefore, applying the GTOS in this patient subgroup warrants careful consideration.

Background/Objectives: Laparoscopic surgery plays a central role in the management of abdominal trauma, particularly in patients with hemodynamic stability. Recently, single-port laparoscopic surgery (SPLS) has emerged as a technique that further reduces access-related trauma while preserving the benefits of conventional laparoscopy. Thus, this review aimed to examine the current landscape of SPLS in trauma care, summarizing available clinical data and highlighting practical considerations for its use. Despite the limited experience, early evidence suggests that SPLS can achieve diagnostic and therapeutic outcomes comparable to those achieved by multi-port approaches in selected cases. Particular attention is given to a hybrid method that combines intracorporeal assessment with extracorporeal small bowel examination and repair through a single umbilical incision. This technique offers a pragmatic balance between thorough exploration and minimal invasiveness. Methods: We searched PubMed, Scopus, Web of Science, and Google Scholar through December 2023 using the terms “single-port laparoscopy”, “single-incision laparoscopic surgery”, “trauma laparoscopy”, and related phrases. Case reports, case series, comparative studies, and reviews describing single-incision laparoscopic surgery in trauma were included in this narrative analysis. Results: SPLS may offer advantages in terms of postoperative pain, wound complications, and cosmetic outcomes, especially in younger patients. As familiarity with the approach increases and dedicated instrumentation becomes more accessible, its role in trauma protocols may expand. Conclusions: Further prospective research is needed to define long-term outcomes, refine patient selection, and integrate SPLS more systematically into trauma care protocols.

Background/Objectives: Trauma remains a leading cause of morbidity and mortality worldwide, significantly affecting younger and aging populations. The regional trauma center establishment in South Korea in 2014 marked a pivotal advancement in the national trauma care system. This study reviews data from the Incheon Regional Trauma Center, analyzing patient demographics, injury mechanisms, and outcome trends. Methods: This retrospective analysis included 32,025 patients with trauma treated at the Incheon Regional Trauma Center from 2014 to 2023. Data from the Korean Trauma Database included demographics, injury mechanisms, Injury Severity Scores (ISSs), and outcomes. We considered the initial treatment setting in our analysis to evaluate its potential impact on patient outcomes. Patients were stratified into four ISS categories and five age groups (0–12, 13–19, 20–64, 65–79, and ≥80 years). Statistical comparisons used chi-square tests and analysis of variance. Results: The proportion of older patients (≥65 years) increased significantly from 23.3% in 2014 to 45.2% in 2023, with patients aged ≥ 80 years showing the highest rise and mortality (6.7%). Traffic accidents decreased from 30.7% to 28.2%, while slip injuries increased from 26.9% to 34.0%. Patients with ISSs > 15 increased, peaking in 2022 (mortality, 15.6%). Despite improved trauma care infrastructure, the overall mortality rate reached 5.9% in 2022, possibly due to more complex cases and an aging population. Conclusions: This study highlights evolving challenges in trauma care due to demographic shifts and rising injury severity. These findings underscore the need for tailored geriatric trauma care, improved infrastructure, and targeted interventions for high-risk groups. Further research is needed to optimize trauma systems and address the growing burden of geriatric trauma.

Purpose: This study aimed to investigate the clinical outcomes after totally implantable access port (TIAP) implantation performed by general surgery residents in patients with colorectal cancer.Methods: A total of 291 consecutive patients who underwent TIAP implantations were evaluated. The patients were divided into threegroups: second-, third-, and fourth-grade residents.Results: The mean follow-up was 22.1 months (range, 1–87 months). The total times of operation, puncture, and cannulation decreased as the resident grade increased (P<0.001). Early complications significantly decreased with higher resident grades (P=0.039). The non-use of ultrasonography and non-use of C-arm were identified as independent risk factors for complications. Resident grades between second and third (P=0.005) and between second and fourth (P=0.041) were identified as independent risk factors for optimal tip position.Conclusion: TIAP implantation can be safely and effectively performed by residents. Low-grade residents were associated with early complications.

Background: Bleeding pelvic fractures have high mortality rates, primarily due to severe hemorrhage. Treatment options include mechanical stabilization based on preperitoneal pelvic packing (PPP), resuscitative endovascular balloon occlusion of the aorta, and angioembolization (AE). The bilateral preperitoneal approach, which uses three pads on each side, is the conventional PPP method. We aimed to compare the bilateral preperitoneal approach with a modified approach, involving selectively packing only heavily bleeding areas, in terms of clinical outcomes and mortality risks. Methods: We included patients who underwent PPP and compared the outcomes between conventional (three sponges placed on each side) and modified PPP (selective packing of critical areas). The primary outcome was 30-day mortality; the secondary outcomes included 24 h mortality, pelvic complications, and transfusion requirements. Univariate and multivariate analyses were performed to determine risk factors for 30-day and 24 h mortality. Results: Among the 47 included patients, 19 and 28 underwent conventional and modified PPP, respectively. There were no significant between-group differences in the 24 h (26.3% vs. 42.9%, p = 0.247) and 30-day mortality rates (47.4% vs. 60.7%, p = 0.366). Using univariate and multivariate analyses, initial lactate levels and the decision to perform AE were found to be significant risk factors for mortality. However, the selected PPP method was not a risk factor for 30-day mortality (odds ratio [OR], 2.22; 95% confidence interval [CI], 0.27–18.26; p = 0.457) or 24 hr mortality (OR, 1.77; 95% CI, 0.24–13.19; p = 0.557). Conclusions: The modified PPP method may be considered in patients with bleeding pelvic fractures for effective bleeding control while minimizing potential complications associated with the conventional PPP.

Traumatic uterine rupture is uncommon but can be fatal and life-threatening for both the mother and infant. In addition to complications caused by trauma itself, such as pelvic fracture, gestational complications such as placental abruption, abortion, premature labor, rupture of membranes, maternal death, and stillbirth can occur. In particular, fetuses have been reported to have a high mortality rate in cases of traumatic uterine rupture. A 36-year-old pregnant female patient fell from the fourth floor and was admitted to our trauma center. We observed large hemoperitoneum, pelvic fractures, and spleen laceration, and the fetus was presumed to be located outside the uterus. The pregnant woman was hemodynamically unstable. Although the fetus was stillborn, angioembolization and surgical treatment were properly performed through collaboration with an interventional radiologist, obstetrician, and trauma surgeons. After two orthopedic operations, the patient was discharged after 34 days. This case report suggests the importance of a multidisciplinary approach in the treatment of pregnant trauma patients.