Association of Direct Helicopter Versus Ground Transport and In-hospital Mortality in Trauma Patients: A Propensity Score Analysis

BackgroundAlthough helmets are associated with reduction in mortality from motorcycle collisions, many states have failed to adopt universal helmet laws for motorcyclists, in part on the grounds that prior research is limited by study design (historical controls) and confounding variables. The goal of this study was to evaluate the association of helmet use in motorcycle collisions with hospital charges and mortality in trauma patients with propensity score analysis in a state without a universal helmet law.MethodsMotorcycle collision data from the Arizona State Trauma Registry from 2014 to 2017 were propensity score matched by regressing helmet use on patient age, sex, race/ethnicity, alcohol intoxication, illicit drug use, and comorbidities. Linear and logistic regression models were used to evaluate the impact of helmet use.ResultsOur sample consisted of 6849 cases, of which 3699 (54.0%) were helmeted and 3150 (46.0%) without helmets. The cohort was 88.1% male with an average age of 40.9±16.0 years. Helmeted patients were less likely to be admitted to the intensive care unit (20.3% vs. 23.7%, OR 0.82 (0.72–0.93)) and ventilated (7.8% vs. 12.0%, OR 0.62 (0.52–0.75)). Propensity-matched analyses consisted of 2541 pairs and demonstrated helmet use to be associated with an 8% decrease in hospital charges (B −0.075 (0.034)) and a 56% decrease in mortality (OR 0.44 (0.31–0.58)).DiscussionIn a state without mandated helmet use for all motorcyclists, the burden of the unhelmeted rider is significant with respect to lives lost and healthcare charges incurred. Although the helmet law debate with respect to civil liberties is complex and unsettled, it appears clear that helmet use is strongly associated with both survival and less economic encumbrance on the state.Level of evidenceLevel III, prognostic and epidemiological.

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IMPACT OF ADDITIONAL ANTIBIOTICS ON IN-HOSPITAL MORTALITY IN PULMONARY TUBERCULOSIS COMPLICATED BY BACTERIAL PNEUMONIA: A PROPENSITY SCORE ANALYSIS

Respirology ◽

10.1111/resp.13420_308 ◽

2018 ◽

Vol 23 ◽

pp. 201-201

Keyword(s):

Propensity Score ◽

Pulmonary Tuberculosis ◽

Hospital Mortality ◽

Bacterial Pneumonia ◽

Propensity Score Analysis ◽

Score Analysis

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Propensity-Score Analysis Reveals that Sex is Not a Prognosis Factor for Mortality in Intensive Care Unit-Admitted Patients with Sepsis

10.21203/rs.3.rs-296848/v1 ◽

2021 ◽

Author(s):

Manuel Ponce-Alonso ◽

Borja M Fernández-Félix ◽

Ana Halperin ◽

Mario Rodríguez-Domínguez ◽

Ana M Sánchez-Díaz ◽

...

Keyword(s):

Propensity Score ◽

Hospital Mortality ◽

Clinical Characteristics ◽

Propensity Score Analysis ◽

Statistical Significance ◽

Prognostic Score ◽

Score Analysis ◽

Infection Source ◽

Comorbidity Index ◽

Univariate Analyses

Abstract Purpose: Classically, men have been considered to have a higher incidence of infectious diseases, with controversy over the possibility that sex could condition the prognosis of the infection. The aim of the present work was to explore this assumption in patients admitted to the ICU with sepsis using a robust statistical analysis.Methods: Retrospective analysis (2006-2017) in patients with microbiologically confirmed bacteremia (n=440) by majoritarian bacterial pathogens. Risk of ICU and in-hospital mortality in males respect to females was compared by an univariant analysis and a propensity score correspondence analysis integrating their clinical characteristics. Results: Relevant differences were related to the infection source: urinary origin for females (28.7% vs 19.8%) and abdominopelvic surgery for males (8.8% vs 4.8%). Sepsis occurred more frequently in males (80.2% vs 76.1%) as well as in-hospital (48.0% vs 41.3%) and ICU (39.9% vs 36.5%) mortality. Escherichia coli was 2 times more frequent in survivors whereas Staphylococcus aureus was 3 times more frequent in deceased patients. Univariate analyses showed that males had a higher Charlson comorbidity index, a poorer McCabe prognostic score; however the propensity score in 296 patients demonstrated that females had higher risk of both ICU (OR 0.72; 95% CI 0.46 to 1.13), and in-hospital mortality (OR 0.84; 95% CI 0.55 to 1.30) but without statistical significance. Conclusion: Men with sepsis have worse clinical characteristics when admitted to the ICU, but sex has no influence on the prognosis of mortality. Our data contributes to help reduce the sex-dependent gap present in health care provision.

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A Propensity Score Analysis of Clostridium difficile Infection among Adult Trauma Patients

Surgical Infections ◽

10.1089/sur.2018.110 ◽

2018 ◽

Vol 19 (7) ◽

pp. 661-666 ◽

Cited By ~ 1

Author(s):

Viktor Gabriel ◽

Areg Grigorian ◽

Jacquelyn L. Phillips ◽

Sebastian D. Schubl ◽

Cristobal Barrios ◽

...

Keyword(s):

Clostridium Difficile ◽

Propensity Score ◽

Clostridium Difficile Infection ◽

Propensity Score Analysis ◽

Trauma Patients ◽

Score Analysis

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Abstract 13226: Epinephrine versus Norepinephrine in Cardiac Arrest Patients With Postresuscitation Shock

Circulation ◽

10.1161/circ.144.suppl_2.13226 ◽

2021 ◽

Vol 144 (Suppl_2) ◽

Author(s):

Wulfran Bougouin ◽

Kaci Slimani ◽

Marie Renaudier ◽

Yannick Binois ◽

Marine Paul ◽

...

Keyword(s):

Cardiac Arrest ◽

Propensity Score ◽

Hospital Mortality ◽

Propensity Score Analysis ◽

Controlled Trial ◽

Cerebral Performance Category ◽

Multivariate Regression Analysis ◽

Sensitivity Analyses ◽

Score Analysis ◽

Hospital Cardiac Arrest

Backgound: Whether epinephrine or norepinephrine is preferable as the continuous intravenous vasopressor used to treat postresuscitation shock is unclear. Objectives: To compare outcomes of patients with postresuscitation shock after out-of-hospital cardiac arrest according to whether the continuous intravenous vasopressor used was epinephrine or norepinephrine. Methods: We conducted an observational multicenter study of consecutive patients managed in 2011-2018 for postresuscitation shock. The primary outcome was all-cause hospital mortality, and secondary outcomes were cardiovascular hospital mortality and unfavorable neurological outcome (Cerebral Performance Category 3 to 5). A multivariate regression analysis and a propensity score analysis were performed, as well as several sensitivity analyses. Results: Of the 766 patients included in five hospitals, 285 (37%) received epinephrine and 481 (63%) norepinephrine. All-cause hospital mortality was significantly higher in the epinephrine group (OR 2.6; 95%CI, 1.4-4.7; P =0.002). Cardiovascular hospital mortality was also higher with epinephrine (aOR 5.5; 95%CI 3.0-10.3; P <0.001), as was the proportion of patients with CPC of 3 to 5 at hospital discharge. Sensitivity analyses produced consistent results. The analysis involving adjustment on a propensity score to control for confounders showed similar findings (aOR 2.1; 95%CI 1.1-4.0; P =0.02). Conclusions: Among patients with postresuscitation shock after out-of-hospital cardiac arrest, use of epinephrine was associated with higher all-cause and cardiovascular-specific mortality, compared with norepinephrine infusion. A randomized controlled trial comparing the two vasopressors in this population is warranted.

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Zero Hospital Mortality and Improved Long Tern Survival in Laparoscopic Hepatectomy for Patients with HCC - A Propensity Score Analysis of 836 Patients

HPB ◽

10.1016/j.hpb.2020.11.088 ◽

2021 ◽

Vol 23 ◽

pp. S37

Author(s):

T.T. Cheung ◽

K.W. Ma ◽

W.H. She ◽

S.H. Tsang ◽

W.C. Dai ◽

...

Keyword(s):

Propensity Score ◽

Hospital Mortality ◽

Propensity Score Analysis ◽

Laparoscopic Hepatectomy ◽

Score Analysis

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Improved Survival for Rural Trauma Patients Transported by Helicopter to a Verified Trauma Center: A Propensity Score Analysis

Academic Emergency Medicine ◽

10.1111/acem.13307 ◽

2017 ◽

Vol 25 (1) ◽

pp. 44-53 ◽

Cited By ~ 7

Author(s):

Thein Hlaing Zhu ◽

Lisa Hollister ◽

Dazar Opoku ◽

Samuel M. Galvagno

Keyword(s):

Propensity Score ◽

Trauma Center ◽

Propensity Score Analysis ◽

Trauma Patients ◽

Score Analysis

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Impact of additional antibiotics on in-hospital mortality in tuberculosis isolated general bacteria: A propensity score analysis

Journal of Infection and Chemotherapy ◽

10.1016/j.jiac.2019.03.022 ◽

2019 ◽

Vol 25 (9) ◽

pp. 714-719 ◽

Cited By ~ 2

Author(s):

Takamasa Kan ◽

Kosaku Komiya ◽

Kokoro Honjo ◽

Sonoe Uchida ◽

Akihiko Goto ◽

...

Keyword(s):

Propensity Score ◽

Hospital Mortality ◽

Propensity Score Analysis ◽

Score Analysis

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Longer Prehospital Time Decreases Reliability of Vital Signs in the Field: A Dual Center Study

The American Surgeon ◽

10.1177/0003134820956941 ◽

2020 ◽

pp. 000313482095694

Author(s):

Morgan Schellenberg ◽

Subarna Biswas ◽

James M. Bardes ◽

Marc D. Trust ◽

Daniel Grabo ◽

...

Keyword(s):

Linear Regression ◽

Propensity Score ◽

Injury Severity ◽

Propensity Score Analysis ◽

Vital Signs ◽

Trauma Team ◽

Trauma Patients ◽

Study Objective ◽

Score Analysis ◽

Prehospital Time

Background Field vital signs are integral in the American College of Surgeons (ASA) Committee on Trauma (COT) triage criteria for trauma team activation (TTA). Reliability of field vital signs in predicting first emergency department (ED) vital signs, however, may depend upon prehospital time. The study objective was to define the effect of prehospital time on correlation between field and first ED vital signs. Methods All highest level TTAs at two Level I trauma centers (2008-2018) were screened. Exclusions were unrecorded prehospital vital signs and those dead on arrival. Demographics, prehospital time (scene time + transport time), injury data, and vital signs were collected. Differences between field and first ED vitals were determined using the paired Student’s t test. Propensity score analysis, adjusting for age, sex, injury severity score (ISS), and mechanism of injury compared outcomes among patients with ISS ≥16. Multivariate linear regression determined impact of prehospital time on vital sign differences between field and ED among propensity-matched patients. Results After exclusions, 21 499 patients remained. Mean prehospital time was 32 vs. 41 minutes ( P < .001). On propensity score analysis, longer prehospital time was associated with significantly greater differences in systolic blood pressure (SBP) ( P < .001), pulse pressure (PP) ( P = .003), and Glasgow Coma Scale (GCS) ( P < .001). On multivariate analysis, linear regression that demonstrated longer prehospital time was associated with greater differences in SBP, heart rate (HR), and PP ( P < .001). Conclusions Field vital signs are less likely to reflect initial ED vital signs when prehospital times are longer. Given the reliance of trauma triage criteria on prehospital vital signs, medical providers must be cognizant of this pitfall during the prehospital assessment of trauma patients.

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