{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:42:14Z","timestamp":1787730134036,"version":"build-2784847793"},"reference-count":42,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T00:00:00Z","timestamp":1734307200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Uncontrolled hemorrhage is a leading cause of preventable death in trauma. Tourniquets (TQs) are commonly used to control bleeding in the prehospital setting, although their application is associated with risks. Therefore, this study aimed to identify complications arising from TQ use and to examine contributing risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This retrospective observational study reviewed the medical records of adult trauma casualties (&gt;18\u2009years) hospitalized at Chaim Sheba Medical Center (SMC) between 2010 and 2020 who had a TQ applied in the prehospital setting. The primary outcome was the rate and type of complications. Logistic regression analyses identified risk factors using demographic, injury, and clinical data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>From 2010 to 2020, a total of 84 trauma casualties with documented prehospital TQ application were hospitalized at SMC. Of these, 20 (23.81%) experienced TQ\u2010related complications, including local infection, compartment syndrome, and thromboembolism. The average TQ application time was 44.2\u2009min, with no significant difference between those with and without complications. However, significant differences were noted in the mechanism of injury (MOI), wound contamination levels, indications for TQ application, and initial blood test results (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Logistic regression analyses revealed length of stay (LOS) and injuries from falls were significantly associated with the development of complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This study found that a significant trauma in prehospital settings requiring TQ application is associated with a high rate of complications. Early complications, including local infections and compartment syndrome, were more frequent, whereas late complications like thromboembolism and muscle atrophy were less common. The findings suggest that factors such as the MOI and wound contamination may contribute to these complications, yet after applying multivariate regression, LOS and falls were the only variables found to be significantly associated with the development of complications. These findings underscore the need for further research comparing casualties with and without TQ application.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.15070","type":"journal-article","created":{"date-parts":[[2024,12,17]],"date-time":"2024-12-17T07:43:53Z","timestamp":1734421433000},"page":"532-541","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The cost of saving lives: Complications arising from prehospital tourniquet application"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0553-2228","authenticated-orcid":false,"given":"Mor","family":"Rittblat","sequence":"first","affiliation":[{"name":"Israeli Defense Forces Medical Corps Tel Hashomer  Ramat Gan Israel"},{"name":"Department of Emergency and Disaster Management, School of Public Health, Faculty of Medical and Health Sciences Tel Aviv University  Tel Aviv\u2010Yafo Israel"},{"name":"Department of Military Medicine and \"Tzameret,\" Faculty of Medicine The Hebrew University of Jerusalem  Jerusalem Israel"},{"name":"Department of Plastic and Reconstructive Surgery Hadassah Hebrew University Medical Centre  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Gendler","sequence":"additional","affiliation":[{"name":"Israeli Defense Forces Medical Corps Tel Hashomer  Ramat Gan Israel"},{"name":"Department of General Surgery, Rabin Medical Center (Beilinson Campus) Tel Aviv University  Petach Tiqva Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nir","family":"Tsur","sequence":"additional","affiliation":[{"name":"Israeli Defense Forces Medical Corps Tel Hashomer  Ramat Gan Israel"},{"name":"Department of Otolaryngology\u2010Head and Neck Surgery, Rabin Medical Center Tel Aviv University  Petach Tiqva 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