Purpose: Maxillofacial trauma may be managed either conservatively or surgically. This study aimed to identify the clinical and radiologic factors associated with operative management in adult patients and to propose a practical, emergency department-based treatment approach. Methods: This retrospective cohort study included adult patients who presented with head and facial trauma between March 1, 2021, and March 1, 2026. Patients aged 18 years or older who had clinical findings suggestive of maxillofacial injury and who underwent maxillofacial computed tomography (CT) were included. Demographic data, trauma mechanism, Glasgow Coma Scale (GCS) score, forensic status, CT findings, consultation, hospitalization, mortality, and treatment were recorded. Patients were divided into operative and nonoperative groups. Descriptive statistics, between-group comparisons, and multivariable logistic regression were performed. Results: A total of 855 patients were included. The mean age was 59.06±22.38 years, and 499 patients (58.4%) were female. Falls were the most common mechanism of injury (74.15%). Surgery was performed in 32 patients (3.74%). Compared with nonoperatively managed patients, those who underwent surgery were younger, more frequently male, had lower GCS scores, and were more often forensic cases. A radiologically confirmed fracture was the strongest independent factor associated with surgery [odds ratio (OR)=11.29; P =0.001], together with forensic status and a lower GCS score. Among patients with radiologically confirmed facial fractures, mandibular, orbital, and nasal fractures were each independently associated with surgery (OR=44.70, 6.54, and 4.44, respectively; all P ≤0.004). Conclusion: Most adult patients with maxillofacial trauma were managed nonoperatively. A radiologically confirmed fracture, forensic status, a lower GCS score, and specific fracture locations—mandibular, orbital, and nasal—may help guide early surgical evaluation and support a simple, practical treatment algorithm.

Background: Early risk stratification of febrile neutropenia (FN) in the emergency department (ED) is vital to accelerate empirical antibiotic management. This study evaluates the independent diagnostic performance of combined blood-borne inflammatory indices and the Shock Index (SI) in predicting FN status and severe clinical outcomes. Methods: Medical records of 338 febrile oncology patients presenting to the ED between 2020 and 2026 were retrospectively evaluated. Patients were divided into the FN group (fever + ANC < 1000 cells/μL; n = 213) and the control group (n = 125). Advanced cell-line metrics and biochemical ratios were calculated at admission. Independent predictors were isolated using multivariable logistic regression analysis. Results: Multivariable regression analysis revealed that elevated core body temperature (aOR: 3.229, 95% CI: 1.845–5.652, p < 0.001), lower serum sodium levels (aOR: 0.843, 95% CI: 0.767–0.926, p < 0.001), a low Neutrophil-to-Lymphocyte Ratio (NLR) (aOR: 0.636, 95% CI: 0.549–0.736, p < 0.001), and an elevated Shock Index (aOR: 24.010, 95% CI: 2.258–255.360, p = 0.008) were stable independent predictors of FN. The combined four-variable integrated model achieved an outstanding Area Under the Curve (AUC) of 0.906 (95% CI: 0.874–0.937) with a diagnostic sensitivity of 77.4% and a specificity of 87.0%. Conclusions: Integrating baseline core temperature, hyponatremia, low cellular NLR, and physiologic SI values creates a rapid, cost-effective, and highly accurate screening platform to optimize emergency triage workflows and prevent computational delivery latency in critical oncologic emergencies.

Aim Point-of-care ultrasound (POCUS) is indispensable in emergency medicine. However, baseline clinician knowledge of standardized international clinical criteria remains suboptimal. This study evaluated theoretical knowledge of international criteria for primary POCUS indications and clinical practice patterns among emergency physicians. Methods This cross-sectional survey assessed emergency medicine residents and specialists using a 25-item Google Forms questionnaire based on the American College of Emergency Physicians (ACEP) Compendium 2021. An expert panel validated the questions. Total knowledge scores (range: 0–15) were calculated dichotomously. Internal consistency was evaluated using the Kuder-Richardson 20 (KR-20) coefficient. Results Final analysis included 98 participants (62.2% male; 37.8% aged 25–29). The mean total knowledge score was 7.12±1.74 (median: 7.00). Proficiency was highest for pediatric appendicitis (90.8%) and lowest for gastrointestinal/bowel ultrasound (4.1%). The tool demonstrated low internal consistency (KR-20 = 0.112), reflecting domain heterogeneity. Total scores did not significantly differ across demographic characteristics or training backgrounds (all P > .05). Multivariable linear regression identified no independent predictors of overall knowledge. In item-level analyses, only the association between specialist experience and lung/pleural ultrasound proficiency survived strict Bonferroni corrections (adjusted P = .029), with younger specialists (≤10 years of experience) outperforming senior colleagues. Conclusion Significant knowledge gaps persist in specialized POCUS domains despite high proficiency in core modalities. Given the high heterogeneity of ultrasound applications, future efforts should move beyond generalized curricula toward standardized, domain-specific continuous education programs to ensure clinical competency.