Chest Trauma Outcomes: Public Versus Private Level I Trauma Centers
| Autor: | Cheryl K. Zogg, Alberto García, Fernando Rosso, Diana Martínez, Luis Fernando Pino, JJ Serna, Alexandra Gómez, Juan P. Herrera-Escobar, Juan José Meléndez, Carlos A. Ordoñez, Michael W. Parra, Claudia P. Orlas, Adolfo González |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Thoracic Injuries Wounds Penetrating Logistic regression Article Young Adult 03 medical and health sciences Injury Severity Score 0302 clinical medicine Trauma Centers Internal medicine medicine Humans Hospital Mortality business.industry Trauma center Hemothorax medicine.disease Mediastinitis Empyema Cardiac surgery Logistic Models 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology Surgery business Penetrating trauma |
| Zdroj: | World J Surg |
| ISSN: | 1432-2323 0364-2313 |
| Popis: | BACKGROUND: The goal of our study was to evaluate the differences in care and clinical outcomes of patients with chest trauma between two hospitals, including one public trauma center (Pu-TC) and one private trauma center (Pri-TC). METHODS: Patients with thoracic trauma admitted from January 2012 to December 2018 at two level I trauma centers (Pu-TC: Hospital Universitario del Valle, Pri-TC: Fundación Valle del Lili) in Cali, Colombia, were included. Multivariable logistic regression was used to assess for differences in in-hospital mortality, adjusting for relevant demographic and clinical characteristics. RESULTS: A total of 482 patients were identified; 300 (62.2%) at the Pri-TC and 182 (37.8%) at the Pu-TC. Median age was 27 years (IQR 21–36) and median Injury Severity Score was 25 (IQR 16–26). 456 patients (94.6%) were male, and the majority had penetrating trauma [total 465 (96.5%); Pri-TC 287 (95.7%), Pu-TC 179 (98.4%), p 0.08]. All patients arrived at the emergency room with unstable hemodynamics. There were no statistically significant differences in post-operative complications, including retained hemothorax [Pri-TC 19 vs. Pu-TC 18], pneumonia [Pri-TC 14 vs. Pu-TC 14], empyema [Pri-TC 13 vs. Pu-TC 13] and mediastinitis [Pri-TC 6 vs. Pu-TC 2]. Logistic regression did, however, show a higher odds of mortality when patients were treated at the Pu-TC [OR 2.27 (95% CI 1.34–3.87, p < 0.001]. CONCLUSIONS: Our study found significant statistical differences in clinical outcomes between patients treated at a Pu-TC and Pri-TC. The results are intended to stimulate discussions to better understand reasons for outcome variability and ways to reduce it. |
| Databáze: | OpenAIRE |
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