دورية أكاديمية
أعرض في EDS

Trauma centre outcome performance: a comparison of young adults and geriatric patients in an inclusive trauma system.

التفاصيل البيبلوغرافية
العنوان: Trauma centre outcome performance: a comparison of young adults and geriatric patients in an inclusive trauma system.
المؤلفون: Moore L; Unite de Traumatologie-Urgence-Soins Intensifs, Centre de Recherche du CHA, Hôpital de l'Enfant-Jésus, Université Laval, Quebec City, Quebec, Canada. lynne.moore.cha@ssss.gouv.qc.ca, Turgeon AF, Sirois MJ, Lavoie A
المصدر: Injury [Injury] 2012 Sep; Vol. 43 (9), pp. 1580-5. Date of Electronic Publication: 2011 Mar 05.
نوع المنشور: Evaluation Study; Journal Article; Multicenter Study
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: Netherlands NLM ID: 0226040 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-0267 (Electronic) Linking ISSN: 00201383 NLM ISO Abbreviation: Injury Subsets: MEDLINE
أسماء مطبوعة: Publication: <2002->: Amsterdam : Elsevier
Original Publication: Bristol, Wright.
مواضيع طبية MeSH: Aged* , Health Status Disparities* , Young Adult*, Patient Transfer/*statistics & numerical data , Wounds and Injuries/*epidemiology, Adolescent ; Aged, 80 and over ; Canada/epidemiology ; Female ; Hospital Mortality ; Humans ; Injury Severity Score ; Male ; Outcome Assessment, Health Care ; Referral and Consultation ; Registries ; Risk Factors ; Trauma Centers ; Treatment Outcome ; Wounds and Injuries/mortality ; Wounds and Injuries/therapy
مستخلص: Background: Elderly trauma patients represent a unique clientele requiring specialised care but they rarely benefit from standardised care strategies within trauma systems. We aimed to evaluate whether trauma centres with lower/higher than expected mortality amongst patients <65 years of age have similar results for geriatric patients. A secondary objective was to compare transfer to level I/II trauma centres across age groups.
Methods: The study was based on data from a Canadian provincial trauma registry (1999-2006). Outcome performance was evaluated with estimates of risk-adjusted 30-day mortality generated for each of the system's 57 adult trauma centres. Agreement in performance results was evaluated with correlation coefficients.
Results: The study sample comprised 55,283 young adults (3.5% mortality) and 30,960 geriatric patients (8.2% mortality). The two age groups only had one out of six outliers in common. Hospital ranks amongst young adults were not correlated to those assigned amongst geriatric patients (r = 0.01, 95%CI -0.25;0.27). Correlation was also low for patients with major trauma (r = 0.20, 95%CI -0.06;0.44). Amongst patients with severe head injuries initially received in a level III/IV centre, 81% of young adults versus 71% of geriatric patients were transferred to a level I/II centre (p<0.0001).
Conclusions: Trauma centres that have low risk-adjusted mortality for young adults do not necessarily do so for geriatric patients. In addition, geriatric patients with severe head injuries are less likely to be treated in neurosurgical trauma centres. Further research is needed to identify determinants of inter-hospital variation in outcome for geriatric trauma patients.
(Copyright © 2011 Elsevier Ltd. All rights reserved.)
تواريخ الأحداث: Date Created: 20110309 Date Completed: 20130408 Latest Revision: 20191210
رمز التحديث: 20231215
DOI: 10.1016/j.injury.2011.02.010
PMID: 21382620
قاعدة البيانات: MEDLINE
الوصف
تدمد:1879-0267
DOI:10.1016/j.injury.2011.02.010