Predictors associated with inappropriate transport of near shore spinal injuries
| Autor: | Quincy K. Tran, Maira Sher Bano, Tucker Lurie, Timothy Traynor |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Medicine (General) medicine.medical_specialty Transport Logistic regression Near shore spinal injury 03 medical and health sciences R5-920 0302 clinical medicine Primary outcome Trauma Centers Odds Ratio Humans Wave riding Medicine Shallow water diving Orthopedics and Sports Medicine In patient Retrospective Studies 030222 orthopedics Adult patients business.industry Trauma center 030208 emergency & critical care medicine Retrospective cohort study Odds ratio Spinal injury Confidence interval Logistic Models Spinal Injuries Emergency medicine Original Article Surgery business |
| Zdroj: | Chinese Journal of Traumatology, Vol 24, Iss 5, Pp 286-290 (2021) Chinese Journal of Traumatology |
| ISSN: | 1008-1275 |
| Popis: | Purpose Spinal injuries resulting in neurological damage cause significant morbidity. Swift neurosurgical intervention can mitigate negative outcomes. However, variable mechanisms of injury may be associated with inappropriate transport (IAT), which may delay necessary surgical interventions. Patients with near shore spinal injuries (NSSI) presented with unique mechanisms, so we investigated factors associated with IAT in patients with NSSI. Methods We performed a multicenter retrospective study of all adult patients transported from a beach resort to 3 hospitals for suspected NSSI between 2006 - 2017. We excluded patients transferred to other facilities, and those not injured in the water. Primary outcome was IAT, defined as patients with NSSI requiring transfer to another trauma center. To avoid heterogeneity in our analysis, we further excluded patients without NSSI who were inappropriately transported to a level I trauma center. We used multivariable logistic regression to assess association of independent variables (such as demographic, environmental, and clinical factors) with outcome. Results We analyzed 278 patients with suspected NSSI, and found 14 (5.0%) had IAT. Compared to appropriately transported patients, diving was associated with higher percentages of IAT (28.6% vs. 3.9%, p = 0.014) and more were transported by air (50.0% vs. 20.6%, p = 0.01). In multivariable regression, patients’ oxygenation saturation (odds ratio [OR] = 0.8, 95% confidence intervals [CI]: 077–0.98) and diving (OR = 7.5, 95% CI: 1.2–46) were significantly associated with IAT. Conclusion Rate of IAT for patients with NSSI was low. However, first responders and emergency medicine providers should be aware that diving is associated with a higher likelihood of IAT. |
| Databáze: | OpenAIRE |
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