Predictors of Trauma High Resource Consumers in a Mature Trauma System
| Autor: | Alan Cook, Andrea Covaci, Frederick B. Rogers, Tawnya M. Vernon, Madison Morgan, Shreya Jammula, Brian W. Gross, Eric H. Bradburn |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Patient demographics Population Logistic regression Young Adult 03 medical and health sciences 0302 clinical medicine Trauma Centers medicine Humans 030212 general & internal medicine education Aged Retrospective Studies Aged 80 and over education.field_of_study business.industry Population mean Glasgow Coma Scale 030208 emergency & critical care medicine General Medicine Length of Stay Middle Aged medicine.disease medicine.anatomical_structure Blood pressure Emergency medicine Health Resources Wounds and Injuries Abdomen Female Gunshot wound business Forecasting |
| Zdroj: | The American Surgeon. 86:486-492 |
| ISSN: | 1555-9823 0003-1348 |
| DOI: | 10.1177/0003134820919723 |
| Popis: | Background Extended hospital length of stay (LOS) is widely associated with significant healthcare costs. Since LOS is a known surrogate for cost, we sought to evaluate outliers. We hypothesized that particular characteristics are likely predictive of trauma high resource consumers (THRC) and can be used to more effectively manage care of this population. Methods The Pennsylvania Trauma Outcome Study database was retrospectively queried from 2003-2017 for all adult (age ≥15) trauma patients admitted to accredited trauma centers in Pennsylvania. THRC were defined as patients with hospital LOS two standard deviations above the population mean or ≥22 days (pResults A total of 465,601 patients met inclusion criteria [THRC: 16,818 (3.6%); non-THRC 448,783 (96.4%)]. Compared to non-THRC counterparts, THRC patients were significantly more severely injured (median ISS: 9 vs. 22, pConclusions Reintubation, major surgery, gunshot wound to abdomen, along with injury to the spine, upper or lower extremities are all strongly predictive of THRC. Understanding the profile of the THRC will allow clinicians and case management to proactively put processes in place to streamline care and potentially reduce costs and LOS. |
| Databáze: | OpenAIRE |
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