| Title |
Demographic Patterns and Outcomes of Patients in Level I Trauma Centers in Three International Trauma Systems
|
|---|---|
| Published in |
World Journal of Surgery, July 2015
|
| DOI | 10.1007/s00268-015-3162-x |
| Pubmed ID | |
| Authors |
Amy C. Gunning, Koen W. W. Lansink, Karlijn J. P. van Wessem, Zsolt J. Balogh, Frederick P. Rivara, Ronald V. Maier, Luke P. H. Leenen |
| Abstract |
Trauma systems were developed to improve the care for the injured. The designation and elements comprising these systems vary across countries. In this study, we have compared the demographic patterns and patient outcomes of Level I trauma centers in three international trauma systems. International multicenter prospective trauma registry-based study, performed in the University Medical Center Utrecht (UMCU), Utrecht, the Netherlands, John Hunter Hospital (JHH), Newcastle, Australia, and Harborview Medical Center (HMC), Seattle, the United States. Inclusion: patients ≥18 years, admitted in 2012, registered in the institutional trauma registry. In UMCU, JHH, and HMC, respectively, 955, 1146, and 4049 patients met the inclusion criteria of which 300, 412, and 1375 patients with Injury Severity Score (ISS) > 15. Mean ISS was higher in JHH (13.5; p < 0.001) and HMC (13.4; p < 0.001) compared to UMCU (11.7). Unadjusted mortality: UMCU = 6.5 %, JHH = 3.6 %, and HMC = 4.8 %. Adjusted odds of death: JHH = 0.498 [95 % confidence interval (CI) 0.303-0.818] and HMC = 0.473 (95 % CI 0.325-0.690) compared to UMCU. HMC compared to JHH was 1.002 (95 % CI 0.664-1.514). Odds of death patients ISS > 15: JHH = 0.507 (95 % CI 0.300-0.857) and HMC = 0.451 (95 % CI 0.297-0.683) compared to UMCU. HMC = 0.931 (95 % CI 0.608-1.425) compared to JHH. TRISS analysis: UMCU: Ws = 0.787, Z = 1.31, M = 0.87; JHH, Ws = 3.583, Z = 6.7, M = 0.89; HMC, Ws = 3.902, Z = 14.6, M = 0.84. This study demonstrated substantial differences across centers in patient characteristics and mortality, mainly of neurological cause. Future research must investigate whether the outcome differences remain with nonfatal and long-term outcomes. Furthermore, we must focus on the development of a more valid method to compare systems. |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 2 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 51 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 1 | 2% |
| Unknown | 50 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 10 | 20% |
| Student > Master | 10 | 20% |
| Student > Bachelor | 7 | 14% |
| Student > Ph. D. Student | 5 | 10% |
| Student > Postgraduate | 4 | 8% |
| Other | 7 | 14% |
| Unknown | 8 | 16% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 29 | 57% |
| Social Sciences | 4 | 8% |
| Biochemistry, Genetics and Molecular Biology | 1 | 2% |
| Nursing and Health Professions | 1 | 2% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 2% |
| Other | 4 | 8% |
| Unknown | 11 | 22% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 02 November 2015.
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#17,765,819
of 22,817,213 outputs
Outputs from World Journal of Surgery
#3,350
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#157,834
of 234,770 outputs
Outputs of similar age from World Journal of Surgery
#42
of 82 outputs
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