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Trauma transfers to a rural level 1 center: a retrospective cohort study

Overview of attention for article published in Journal of Trauma Management & Outcomes, January 2016
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2 tweeters

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Title
Trauma transfers to a rural level 1 center: a retrospective cohort study
Published in
Journal of Trauma Management & Outcomes, January 2016
DOI 10.1186/s13032-016-0031-z
Pubmed ID
Authors

Sumeet V Jain, Castigliano M Bhamidipati, Robert N Cooney

Abstract

The regionalization of trauma care, the Emergency Medical Treatment and Active Labor Act of 1986, the advent of Accountable Care Organizations and bundled payments have brought Level 1 trauma centers (TC) to a new crossroads. By protocol, injured patients are preferentially transferred to designated TCs when a higher level of care is indicated. Trauma transfers frequently come during off hours and may not always appear to be related to injury severity. Based on this observation, we hypothesized patients transferred from regional hospitals to Level 1 TCs would have lower injury severity scores (ISS) and unfavorable payor status. We queried our TC registry to identify trauma transfers (TTP) and primary trauma patients (PTP) treated at our level 1 TC between 2004 and 2012. Demographics, payor status, length of stay (LOS), injury severity score (ISS), and discharging service were compared. 5699 TTP and 11147 PTP were identified. Uninsured patients comprised 11 % (n = 602) of TTP compared with 15 % (n = 1,721) of PTP (P < 0.0001). Surprisingly 52 % of TTP were Medicare or HMO (n = 3008) beneficiaries, versus 42 % of PTP being Medicare or HMO (n = 4614) recipients (P < 0.0001). Patients were discharged predominantly by neurosurgery and orthopedic surgery (i.e.: General Adult and General Pediatric comprised <50 % of discharges) for all trauma admissions. Adult and Pediatric Trauma services accounted for 29 % (n = 1674) of TTP versus 45 % of PTP (n = 5045) discharges (P < 0.0001). Mean Injury Severity Score of TTP was found to be 11.5 ± 0.11, in comparison to 11.6 ± 0.11 in PTP (P = 0.42), while mean LOS was 5.6 ± 0.1 days for TTP and 5.9 ± 0.1 days for PTP (P = 0.06). These data suggest designated trauma centers should continue to encourage and accept appropriate transfer of trauma patients for surgical subspecialty care. The perception trauma transfers increase institutional fiscal burden is unsubstantiated.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 16 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 6%
United States 1 6%
Unknown 14 88%

Demographic breakdown

Readers by professional status Count As %
Other 2 13%
Student > Postgraduate 2 13%
Professor 2 13%
Student > Ph. D. Student 2 13%
Student > Bachelor 1 6%
Other 4 25%
Unknown 3 19%
Readers by discipline Count As %
Medicine and Dentistry 6 38%
Social Sciences 2 13%
Nursing and Health Professions 1 6%
Unknown 7 44%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. 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 19 January 2016.
All research outputs
#9,587,447
of 15,640,884 outputs
Outputs from Journal of Trauma Management & Outcomes
#27
of 52 outputs
Outputs of similar age
#168,077
of 342,605 outputs
Outputs of similar age from Journal of Trauma Management & Outcomes
#1
of 1 outputs
Altmetric has tracked 15,640,884 research outputs across all sources so far. This one is in the 36th percentile – i.e., 36% of other outputs scored the same or lower than it.
So far Altmetric has tracked 52 research outputs from this source. They receive a mean Attention Score of 3.2. This one is in the 44th percentile – i.e., 44% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 342,605 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 47th percentile – i.e., 47% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them