Impact of Insurance Expansion on Disposition for Pediatric Trauma Patients: A National Trauma Data Bank Cohort Study

Rapid transfer of trauma patients to a trauma center for definitive management is essential to increase survival. The utilization of helicopter transportation for this purpose remains heavily debated. The purpose of this study was to characterize the trends in helicopter transportations of trauma patients in the United States over the last decade. Subjects with a primary mode of either ground or helicopter transportation were selected from the National Trauma Data Bank datasets 2007 to 2015. Over this period, the proportion of patients transported by a helicopter decreased significantly in a linear fashion from 17 per cent in 2007 to 10.2 per cent in 2015 ( P < 0.001). The overall mortality of this population was 7.6 per cent and remained unchanged over the study period ( P = 0.545). Almost 3 of 10 subjects (29.4%) transported by a helicopter had an Injury Severity Score <9. The proportion of elderly (>65 years) patients requiring helicopter transportation increased by 69.1 per cent, whereas their associated mortality decreased by 21.5 per cent. The use of a helicopter for the transportation of trauma patients has significantly decreased over the last decade without any significant change in mortality, possibly indicating more effective utilization of available resources. Overtriage of patients with minor injuries remained relatively unchanged.

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Farm Injuries: Animal Most Common, Machinery Most Lethal: An NTDB Study

The American Surgeon ◽

10.1177/000313481908500737 ◽

2019 ◽

Vol 85 (7) ◽

pp. 752-756

Author(s):

Karl Damroth ◽

Rachel Damroth ◽

Asad Chaudhary ◽

Anfin Erickson ◽

Liam Heneghan ◽

...

Keyword(s):

Injury Severity ◽

Data Bank ◽

Trauma Patients ◽

Age Group ◽

Fatality Rate ◽

P Values ◽

Injury Type ◽

National Trauma ◽

National Trauma Data Bank ◽

Farm Injuries

To characterize both emergency room (ER) and hospital discharge dispositions of patients presenting with farm-related injuries. The 2012 National Trauma Data Bank was queried in August 2017 for injuries occurring on a farm. Patients were stratified by gender, age group, race, Injury Severity Score (ISS), and injury type. We performed logistic regression analysis to correlate parameters with likelihood of discharge home or death. P values < 0.05 were considered significant. Five thousand six hundred thirty-one patients were identified, the majority of whom were male (72%) and white (85%). The most common mechanisms of injury included animal-related (29%), followed by falls, vehicles, and other causes. The highest ISSs were seen in vehicular injuries (11% ISS of 251) and the greatest fatality rate was seen in machinery injuries (4%). Four thousand seven hundred fifty-three (84%) patients were admitted to the hospital, and 4056 (72%) were discharged home from the ER or after hospitalization. One hundred thirty patients (2%) died of their farm-related injury. Most patients presenting to the ER with farm-related injuries survive, are admitted to the hospital, and are ultimately discharged home. Few patients die of their injuries. Animal injury is most common and machinery injury most lethal of farm trauma patients presenting to the ER.

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Survival prediction of trauma patients: a study on US National Trauma Data Bank

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-016-0757-3 ◽

2017 ◽

Vol 43 (6) ◽

pp. 805-822 ◽

Cited By ~ 2

Author(s):

I. Sefrioui ◽

R. Amadini ◽

J. Mauro ◽

A. El Fallahi ◽

M. Gabbrielli

Keyword(s):

Data Bank ◽

Survival Prediction ◽

Trauma Patients ◽

National Trauma ◽

National Trauma Data Bank

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Epidemiology of Traumatic Esophageal Injury: An Analysis of the National Trauma Data Bank

The American Surgeon ◽

10.1177/000313481908500422 ◽

2019 ◽

Vol 85 (4) ◽

pp. 342-349 ◽

Cited By ~ 1

Author(s):

Alexander A. Xu ◽

Janis L. Breeze ◽

Jessica K. Paulus ◽

Nikolay Bugaev

Keyword(s):

Injury Severity Score ◽

Severity Score ◽

Injury Severity ◽

Traumatic Injury ◽

Data Bank ◽

Esophageal Injury ◽

Trauma Patients ◽

Adult Age ◽

National Trauma ◽

National Trauma Data Bank

Existing literature on traumatic injury of the esophagus (TIE) is limited. We aimed to describe the clinical characteristics and outcomes of TIE. We reviewed the National Trauma Data Bank for the years 2010–2015. We described the demographics, characteristics, and outcomes of adult (age ≥16 years) TIE patients and also compared those factors in blunt versus penetrating TIE. The association between TIE and mortality was analyzed using multivariable logistic regression. Thousand four hundred eleven adult TIE patients were identified (37 per 100,000 trauma patients, 95% confidence intervals (CI): 35, 39). TIE patients were younger (38 vs 52 years), more likely to be male (81% vs 62%), and more severely injured (Injury Severity Score ≥ 25: 45% vs 7%) than patients without TIE (all P < 0.001). TIE was observed 16 times more frequently with penetrating injuries (257 per 100,000, 95% CI: 240, 270) than with blunt injuries (16 per 100,000, 95% CI: 15, 18). Inhospital TIE mortality was 19 per cent. TIE patients had greater risk of mortality than other trauma patients, after adjusting for age, gender, and Injury Severity Score (odds ratio = 1.4, 95% CI: 1.1, 1.7). Mortality in blunt and penetrating TIE did not differ. Although extremely rare, TIE is independently associated with a marked increase in mortality, even after adjusting for other risk factors.

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