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Geriatric outcomes for trauma patients in the state of Florida after the advent of a large trauma network
- Source :
- The journal of trauma and acute care surgery. 77(1)
- Publication Year :
- 2014
-
Abstract
- BACKGROUND Florida State has one of the largest geriatric populations in the United States. However, recent data show that up to the year 2010, geriatric trauma patients were least served by designated trauma centers (TCs). One existing TC and five provisional Level 2 TCs were combined to create a large-scale trauma network (TN). The new TCs were placed in those areas with the lowest ratios of TC to residents based on census data. The aim of this study was to measure the TN impact on the population of geriatric trauma patients. METHODS Data from the Florida State Agency for Health Care Administration were used to determine mortality, length of stay, and complication rates for geriatric trauma patients (≥ 65 years). The potential effect of the TN was measured by comparing outcomes before and after the initiation of the TN. A total of 165,640 geriatric patients were evaluated. Multivariate regression methods were used to match and adjust for age, injury status (penetrating vs. nonpenetrating), sex, race, comorbidity, and injury severity (DRG International Classification of Diseases-9th Rev. Injury Severity Score). RESULTS Since the advent of the TN, an additional 1,711 geriatric patients were treated compared with the previous period. The TN was responsible 86% of these new patients. There was a temporal association with a decrease in both mortality (adjusted odds ratio, 0.90; 95% confidence interval, 0.85-0.96) and length of stay (p < 0.0001) for geriatric patients since the advent of the TN. The improved access was associated with a significant decrease in mortality in the regions serviced by the TN. CONCLUSION Geriatric patients make up a significant proportion of trauma patients within the TN. The temporal improvement in outcomes may be associated with the increased proportion of patients being treated in state-designated TCs as a result of the addition of the TN. LEVEL OF EVIDENCE Epidemiologic study, level III.
- Subjects :
- Male
medicine.medical_specialty
Pediatrics
Population
Wounds, Penetrating
Comorbidity
Critical Care and Intensive Care Medicine
Wounds, Nonpenetrating
Health Services Accessibility
Health administration
Injury Severity Score
Geriatric trauma
Trauma Centers
Internal medicine
Outcome Assessment, Health Care
medicine
Humans
Hospital Mortality
education
Aged
Retrospective Studies
Aged, 80 and over
education.field_of_study
business.industry
Odds ratio
Length of Stay
medicine.disease
Confidence interval
Logistic Models
Multivariate Analysis
Florida
Wounds and Injuries
Surgery
Female
business
Complication
Subjects
Details
- ISSN :
- 21630763
- Volume :
- 77
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- The journal of trauma and acute care surgery
- Accession number :
- edsair.doi.dedup.....9039666ba6066ecd98f04335b9e619d8