Trauma Surgery

New persistent opioid use occurs in about 7% of opioid‑naïve surgical patients in the USA.

This meta‑analysis pooled 43 observational studies (n=6,507,173) and estimated a pooled NPOU incidence of 7.15% (95% CI 6.02–8.38). Heterogeneity was very high (I2=100%) with a 95% prediction interval of 1.34%–17.02%, reflecting definition and study differences. Studies using a 90–180 day definition reported higher incidence (8.29%) than stricter 180‑day definitions (2.89%). Implication: consider protocolized opioid minimization and follow-up for persistent use after discharge. 1

Timing of surgical stabilization of rib fractures compared with nonoperative care—respiratory outcomes reported.

This cohort study compared early, intermediate, and late surgical rib fixation versus nonoperative management for blunt chest trauma. The abstract reports respiratory outcomes but does not provide effect sizes or adjusted estimates for timing comparisons. Implication: with timing studies vulnerable to selection bias, wait for detailed adjusted results before changing practice. Consider individualizing fixation timing based on respiratory trajectory, pain control, and physiologic reserve. 2

PJI outcome reporting is highly heterogeneous; a working core outcome set is proposed.

This meta‑epidemiologic review included 461 studies and found major heterogeneity in PJI outcome definitions across seven domains. Most studies were retrospective (416/461) with few RCTs (8) and limited use of patient‑reported outcome measures (111 studies). The authors propose a working core outcome set to harmonize reporting and improve comparability for future research. Implication: adopt standardized outcome sets in PJI research and include PROMs when feasible for patient‑centered assessment. 3