Journal article
Outcome of Hypotensive Trauma Patients by Time and Day of Arrival
The Journal of surgical research, v 258, pp 113-118
01 Feb 2021
PMID: 33010555
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Although most studies of trauma patients have not demonstrated a "weekend" or "night" effect on mortality, outcomes of hypotensive (systolic blood pressure <90 mm Hg) patients have not been studied. We sought to evaluate whether outcomes of hypotensive patients were associated with admission time and day.
Methods: We retrospectively analyzed patients from Pennsylvania Level 1 and Level 2 trauma centers with systolic blood pressure of <90 mm Hg over 5 y. Patients were stratified into four groups by arrival day and time: Group 1, weekday days; Group 2, weekday nights; Group 3, weekend days; and Group 4, weekend nights. Patient characteristics and outcomes were compared for the four groups. Adjusted mortality risks for Groups 2, 3, and 4 with Group 1 as the reference were determined using a generalized linear mixed effects model.
Results: After exclusions, 27 trauma centers with a total of 4937 patients were analyzed. Overall mortality was 44%. Compared with patients arriving during the day (Groups 1 and 3), those arriving at night (Groups 2 and 4) were more likely to be younger, to be male, to have lower Glasgow Coma Scale scores and blood pressures, to have penetrating injuries, and to die in the emergency room. Controlled for admission variables, odds ratios (95% confidence intervals) for Groups 2, 3, and 4 were 0.92 (0.72-1.17), 0.89 (0.65-1.23), and 0.76 (0.56-1.02), respectively, for mortality with Group 1 as reference.
Conclusions: Patients arriving in shock to Pennsylvania Level 1 and Level 2 trauma centers at night or weekends had no increased mortality risk compared with weekday daytime arrivals. (C) 2020 Elsevier Inc. All rights reserved.
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Details
- Title
- Outcome of Hypotensive Trauma Patients by Time and Day of Arrival
- Creators
- Adrian W. Ong - University of PennsylvaniaJacqueline Stephenson - Philadelphia College of Osteopathic MedicineKrista J. Gile - Univ Massachusetts, Dept Math & Stat, Amherst, MA 01003 USARachel A. Aronow - Univ Massachusetts, Dept Math & Stat, Amherst, MA 01003 USAXiaoyun Wang - Univ Massachusetts, Dept Math & Stat, Amherst, MA 01003 USAYuting Xu - Univ Massachusetts, Dept Math & Stat, Amherst, MA 01003 USANiels D. Martin - University of PennsylvaniaPatrick K. Kim - University of PennsylvaniaForrest B. Fernandez - Reading Hospital
- Publication Details
- The Journal of surgical research, v 258, pp 113-118
- Publisher
- Elsevier
- Number of pages
- 6
- Grant note
- Pennsylvania Trauma Systems Foundation through a research Grant Award
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000600487500002
- Scopus ID
- 2-s2.0-85091802205
- Other Identifier
- 991022020636004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Surgery