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The volume-outcome relationship among severely injured patients admitted to English major trauma centres: a registry study

التفاصيل البيبلوغرافية
العنوان: The volume-outcome relationship among severely injured patients admitted to English major trauma centres: a registry study
المؤلفون: Dennis den Hartog, Esmee Venema, Charlie A. Sewalt, Fiona Lecky, Eveline J. A. Wiegers, Stephanie C. E. Schuit, Hester F. Lingsma
المساهمون: Public Health, Surgery, Emergency Medicine, Internal Medicine, Neurology
المصدر: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, Vol 28, Iss 1, Pp 1-8 (2020)
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, 28(1):18. BioMed Central Ltd.
بيانات النشر: BMC, 2020.
سنة النشر: 2020
مصطلحات موضوعية: Adult, Male, medicine.medical_specialty, Registry study, Critical Care and Intensive Care Medicine, Logistic regression, Time-to-Treatment, Severely injury, 03 medical and health sciences, Injury Severity Score, 0302 clinical medicine, Trauma Centers, 0502 economics and business, Odds Ratio, medicine, Humans, Hospital Mortality, Registries, Aged, Retrospective Studies, Original Research, Wales, Quality of trauma care, Volume outcome, business.industry, Major trauma, 05 social sciences, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, Volume-outcome relationship, Odds ratio, lcsh:RC86-88.9, Middle Aged, medicine.disease, Confidence interval, Hospitalization, Logistic Models, England, Emergency medicine, Emergency Medicine, Wounds and Injuries, Female, 050211 marketing, business, Cohort study
الوصف: Background Many countries have centralized and dedicated trauma centres with high volumes of trauma patients. However, the volume-outcome relationship in severely injured patients (Injury Severity Score (ISS) > 15) remains unclear. The aim of this study was to determine the association between hospital volume and outcomes in Major Trauma Centres (MTCs). Methods A retrospective observational cohort study was conducted using the Trauma Audit and Research Network (TARN) consisting of all English Major Trauma Centres (MTCs). Severely injured patients (ISS > 15) admitted to a MTC between 2013 and 2016 were included. The effect of hospital volume on outcome was analysed with random effects logistic regression models with a random intercept for centre and was tested for nonlinearity. Primary outcome was in-hospital mortality. Results A total of 47,157 severely injured patients from 28 MTCs were included in this study. Hospital volume varied from 69 to 781 severely injured patients per year. There were small between-centre differences in mortality after adjusting for important demographic and injury severity characteristics (adjusted 95% odds ratio range: 0.99–1.01). Hospital volume was found to be linear and not associated with in-hospital mortality (adjusted odds ratio (aOR) 1.02 per 10 patients, 95% confidence interval (CI) 0.68–1.54, p = 0.92). Conclusions Despite the large variation in volume of the included MTCs, no relationship between hospital volume and outcome of severely injured patients was found. These results suggest that centres with similar structure and processes of care can achieve comparable outcomes in severely injured patients despite the number of severely injured patients they treat.
وصف الملف: application/pdf
اللغة: English
تدمد: 1757-7241
URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f4ae887874007f8b568d6d0d15190763
http://link.springer.com/article/10.1186/s13049-020-0710-7
حقوق: OPEN
رقم الأكسشن: edsair.doi.dedup.....f4ae887874007f8b568d6d0d15190763
قاعدة البيانات: OpenAIRE
الوصف
تدمد:17577241