Impact of trauma center volume on major vascular injury: An analysis of the National Trauma Data Bank (NTDB)

2020 ◽  
Vol 220 (3) ◽  
pp. 787-792
Author(s):  
Sharven Taghavi ◽  
Glenn Jones ◽  
Juan Duchesne ◽  
Patrick McGrew ◽  
Chrissy Guidry ◽  
...  
2021 ◽  
Vol 264 ◽  
pp. 499-509
Author(s):  
Sung Huang Laurent Tsai ◽  
Greg Michael Osgood ◽  
Joseph K. Canner ◽  
Amber Mehmood ◽  
Oluwafemi Owodunni ◽  
...  

2006 ◽  
Vol 44 (1) ◽  
pp. 94-100 ◽  
Author(s):  
Philip S. Mullenix ◽  
Scott R. Steele ◽  
Charles A. Andersen ◽  
Benjamin W. Starnes ◽  
Ali Salim ◽  
...  

Injury ◽  
2012 ◽  
Vol 43 (9) ◽  
pp. 1486-1491 ◽  
Author(s):  
Alik Farber ◽  
Tze-Woei Tan ◽  
Naomi M. Hamburg ◽  
Jeffrey A. Kalish ◽  
Fernando Joglar ◽  
...  

2020 ◽  
Vol 16 (5) ◽  
pp. 658.e1-658.e9
Author(s):  
Amr Mahran ◽  
Austin Fernstrum ◽  
Michael Swindle ◽  
Kirtishri Mishra ◽  
Laura Bukavina ◽  
...  

2015 ◽  
Vol 81 (10) ◽  
pp. 927-931
Author(s):  
Shin Miyata ◽  
Tobias Haltmeier ◽  
Kenji Inaba ◽  
Kazuhide Matsushima ◽  
Catherine Goodhue ◽  
...  

The American College of Surgeons Committee on Trauma stratification system for trauma centers presumes that increasing levels of resources will improve patient outcomes. Although some supportive data exist in adult trauma, there is a paucity of evidence demonstrating improved survival in pediatric trauma when patients are treated primarily at Level I versus Level II pediatric trauma centers. We hypothesized that there is no difference in the mortality of comparably injured pediatric patients treated at these two types of facilities. The study population consists of all severely injured pediatric patients (18 years old or younger, injury severity score > 15) registered in the National Trauma Data Bank, treated in designated pediatric trauma centers. A total of 13,803 patients were included in the analysis and were separated into two groups: Pediatric Level I trauma center (n = 9690) and Pediatric Level II trauma center (n = 4113). Although analysis of the clinical characteristics of the unmatched groups showed significant differences including mortality rate (11.7% vs 15.4%, P < 0.001), case matching technique, comparing 2956 pairs, successfully eliminated demographic differences and, when adjusted for injury severity, showed no difference in mortality between center types (10.0% vs 10.1%, P = 0.966, odds ratio of mortality = 0.996 and 95% confidence interval = 0.841–1.180). Subgroup analyses including Glasgow Coma Scale < 9, need for immediate procedures, and ICD-9 (International Classification of Diseases) code groupings indicative of serious injury also failed to demonstrate statistically significant differences in mortality between trauma center types.


2012 ◽  
Vol 215 (3) ◽  
pp. S154
Author(s):  
Charles S. Briggs ◽  
Tze-Woei Tan ◽  
Naomi Hamburg ◽  
Robert Eberhardt ◽  
Gheorghe Doros ◽  
...  

2012 ◽  
Vol 55 (6) ◽  
pp. 68S
Author(s):  
Charles Briggs ◽  
Tze-Woei Tan ◽  
Denis Rybin ◽  
Gheorghe Doros ◽  
Robert Eberhardt ◽  
...  

2019 ◽  
Vol 85 (3) ◽  
pp. 292-293
Author(s):  
Ethan Talbot ◽  
Suzanne Evans ◽  
Nicholas Hellenthal ◽  
Daphne Monie ◽  
Paul Campbell ◽  
...  

The aim of this study was to characterize the outcomes of traumatic abdominal and pelvic vascular injuries. Using the 2012 National Trauma Data Bank, we identified 5858 patients with major abdominal and/or pelvic vascular injury. Patients were stratified by age group, gender, race, Injury Severity Score (ISS), and mechanism of injury. We evaluated the percentage of patients with blunt and penetrating trauma by demographic and correlated the mechanism of injury to the ISS score, emergency room disposition, and hospital disposition. We performed a logistic regression analysis to calculate predictors of death. In the final cohort, 1458 patients (25%) with abdominal/pelvic vascular injury died of trauma. In total, 3368 patients (57%) had a blunt mechanism of injury, whereas 2353 (40%) were victims of a penetrating trauma. Patients with penetrating injuries were 1.72 times more likely to die from their injuries than those with blunt traumas. Patients with higher ISS scores (>16) were more likely to die from their injuries than patients with lower ISS scores. Men were more likely to experience a penetrating vascular injury than women (48% vs 17%). Similarly, 77 per cent of black patients had a penetrating mechanism of injury compared with 20 per cent of white patients. There were 1910 patients with penetrating injuries (81%) that went immediately from the emergency room to the OR, compared with 1287 patients with blunt injuries (38%). Of the patients with blunt injuries, 695 (21%) died, whereas 727 (31%) patients with penetrating injuries died. Abdominal and pelvic traumatic vascular injuries carry a high mortality rate. Penetrating mechanism of injury, ISS score, and race are independent predictors of mortality.


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