Effects of Time of Arrival on Trauma Patient Outcomes.

Autor:	LaRosa SK; Department of Surgery, Division of Trauma and Acute Care Surgery, Penn Medicine Lancaster General Health, Lancaster, PA, USA., Stone XA; Department of Surgery, Division of Trauma and Acute Care Surgery, Penn Medicine Lancaster General Health, Lancaster, PA, USA., Fenninger AA; Department of Surgery, Division of Trauma and Acute Care Surgery, Penn Medicine Lancaster General Health, Lancaster, PA, USA., Harshaw NS; Department of Surgery, Division of Trauma and Acute Care Surgery, Penn Medicine Lancaster General Health, Lancaster, PA, USA., Hoffman KM; Department of Surgery, Philadelphia College of Osteopathic Medicine, Philadelphia, PA, USA., Moore KG; Department of Surgery, Division of Trauma and Acute Care Surgery, Penn Medicine Lancaster General Health, Lancaster, PA, USA., Perea LL; Department of Surgery, Division of Trauma and Acute Care Surgery, Penn Medicine Lancaster General Health, Lancaster, PA, USA.
Jazyk:	angličtina
Zdroj:	The American surgeon [Am Surg] 2024 Sep; Vol. 90 (9), pp. 2188-2193. Date of Electronic Publication: 2024 Apr 22.
DOI:	10.1177/00031348241248694
Abstrakt:	Background: Arriving during "off hours" to the hospital can put patients at greater risk of complications or mortality given lesser staff. Our goal was to investigate this in trauma patients with an Injury Severity Score (ISS) of >15. We hypothesized that the patients admitted late at night and/or during the weekend, would have worse outcomes, delays to the operating room (OR), and longer lengths of stay (LOS) compared to those who arrive on a weekday during the day. Methods: We performed a retrospective study from 8/1/2019 to 8/1/2022 of all trauma patients with an ISS >15 at our Level 1 Trauma Center. Patients <18 years, dead on arrival, or transferred out were excluded. Univariate and multivariable analysis were performed comparing weekday vs weekend arrivals, day vs night shift arrivals, and with patients grouped as weekday day, weekday night, weekend day, and weekend night. The primary outcome was mortality. Results: 953 patients met inclusion criteria. The patients that arrived on the weekend and at night were significantly younger than their counterparts. A significantly greater percentage of Black patients arrived during night shift. Mortality, hospital LOS, and ICU LOS did not differ based on day or time of arrival. Conclusion: Contrary to our hypothesis, our study did not find a significant difference in outcomes when evaluating based on a patient's time of arrival. This gives credence that our mature trauma center can provide the same level of care despite the time of a severely injured patient's time of arrival. Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Databáze:	MEDLINE
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