دورية أكاديمية
Undertriage of Geriatric Trauma Patients in Florida.
| العنوان: | Undertriage of Geriatric Trauma Patients in Florida. |
|---|---|
| المؤلفون: | Weber C; University of Central Florida, General Surgery, Ocala, Florida., Millen JC; University of Central Florida, General Surgery, Ocala, Florida., Liu H; Department of Trauma, Ocala Regional Medical Center, Ocala, Florida., Clark J; University of Central Florida, General Surgery, Ocala, Florida; Department of Surgery, University of South Florida, Tampa, Florida; Department of Trauma, Ocala Regional Medical Center, Ocala, Florida., Ferber L; University of Central Florida, General Surgery, Ocala, Florida; Department of Surgery, University of South Florida, Tampa, Florida; Department of Trauma, Ocala Regional Medical Center, Ocala, Florida., Richards W; University of Central Florida, General Surgery, Ocala, Florida; Department of Surgery, University of South Florida, Tampa, Florida; Department of Trauma, Ocala Regional Medical Center, Ocala, Florida., Ang D; University of Central Florida, General Surgery, Ocala, Florida; Department of Surgery, University of South Florida, Tampa, Florida; Department of Trauma, Ocala Regional Medical Center, Ocala, Florida. Electronic address: Darwin.Ang@hcahealthcare.com. |
| المصدر: | The Journal of surgical research [J Surg Res] 2022 Nov; Vol. 279, pp. 427-435. Date of Electronic Publication: 2022 Jul 13. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Academic Press Country of Publication: United States NLM ID: 0376340 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-8673 (Electronic) Linking ISSN: 00224804 NLM ISO Abbreviation: J Surg Res Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: New York, NY : Academic Press Original Publication: Philadelphia [etc.] |
| مواضيع طبية MeSH: | Trauma Centers* , Wounds and Injuries*/diagnosis , Wounds and Injuries*/therapy, Aged ; Florida/epidemiology ; Humans ; Injury Severity Score ; Retrospective Studies ; Triage ; United States |
| مستخلص: | Introduction: Elderly undertriage rates are estimated up to 55% in the United States. This study examined risk factors for undertriage among hospitalized trauma patients in a state with high volumes of geriatric trauma patients. Materials and Methods: This is a population-based retrospective cohort study of 62,557 patients admitted to Florida hospitals between 2016 and 2018 from the Agency for Healthcare Administration database. Severely injured trauma patients were defined by American College of Surgeons definitions and an International Classification of Disease Injury Severity Score <0.85. Undertriage was defined as definitive care of these severely injured patients at any Florida hospital other than a state-designated trauma center (TC). Univariate analyses were used to identify risk factors associated with inpatient mortality and undertriage. Multiple variable regression was used to estimate risk-adjusted odds of mortality after admission to either a designated or nondesignated TC. Results: Undertriaged patients were more likely to have isolated traumatic brain injuries, lower International Classification of Disease Injury Severity Scores, multiple comorbidities, and older age. Trauma patients aged 65 and older were more than twice as likely to be undertriaged (34% versus 15.7%, P < 0.0001). Undertriaged patients of all ages were also more likely to suffer from pneumonia, urinary tract infection, arrhythmias, and sepsis. After risk adjustment, severely injured trauma patients admitted to non-TC were also more likely to be at risk for mortality (adjusted odds ratio, 1.27; 95% confidence interval, 1.17-1.38). Conclusions: Age and multiple comorbidities are significant predictors of mortality among undertriage of trauma patients. As a result, trauma triage guidelines should account for high-risk geriatric trauma patients who would benefit from definitive treatment at designated TCs. (Copyright © 2022 Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Florida geriatric trauma; Geriatric trauma; Geriatric undertriage; Trauma center undertriage; Undertriage |
| تواريخ الأحداث: | Date Created: 20220716 Date Completed: 20220923 Latest Revision: 20221204 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1016/j.jss.2022.06.006 |
| PMID: | 35841811 |
| قاعدة البيانات: | MEDLINE |
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