domingo, 23 de diciembre de 2012

Outcomes of adult trauma patients admitted to trau... [Arch Surg. 2012] - PubMed - NCBI

Outcomes of adult trauma patients admitted to trau... [Arch Surg. 2012] - PubMed - NCBI

Arch Surg. 2012 Aug;147(8):732-7. doi: 10.1001/archsurg.2012.1138.

Outcomes of adult trauma patients admitted to trauma centers in Pennsylvania, 2000-2009.

Source

Department of Anesthesiology, University of Rochester Medical Center, 601 Elmwood Ave, PO Box 604, Rochester, NY 14642, USA. laurent_glance@urmc.rochester.edu

Abstract

OBJECTIVE:

To examine longitudinal trends in mortality for injured patients admitted to trauma centers.

DESIGN, SETTING, AND PARTICIPANTS:

Retrospective cohort design of 208 866 patients admitted to level I or level II trauma centers in Pennsylvania between 2000 and 2009 using the Pennsylvania Trauma Outcome Study database. Multivariate logistic regression was used to estimate the temporal trend for in-hospital mortality.

MAIN OUTCOME MEASURES:

Patients were stratified by injury severity to estimate mortality trends in patients with low-severity, moderate, severe, and very severe injuries.

RESULTS:

Comparing 2000-2001 data with 2008-2009 data, the odds of mortality decreased by 29% (adjusted odds ratio [AOR] = 0.71; 95% CI, 0.59-0.85) and the odds of major complications decreased by 32% (AOR = 0.68; 95% CI, 0.57-0.81). Between 2000 and 2009, the mortality rate for patients admitted with moderate trauma decreased by 42% (AOR = 0.58; 95% CI, 0.46-0.71) and the mortality rate for patients with severe trauma decreased by 51% (AOR = 0.49; 95% CI, 0.40-0.60). Mortality rates for patients admitted with mild trauma or with very severe trauma did not change significantly during this period.

CONCLUSIONS:

In-hospital mortality and major complications for adult trauma patients admitted to level I or level II trauma centers declined by 30% between 2000 and 2009. After stratifying patients by injury severity, the mortality rate for patients presenting with moderate or severe injuries declined by 40% to 50%, whereas mortality rates remained unchanged in patients with the least severe or the most severe injuries.
PMID:
22911068
[PubMed - indexed for MEDLINE]

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