TY - JOUR
T1 - Predictive effect of out-of-hospital time in outcomes of severely injured young adult and elderly patients
AU - Báez, Amado Alejandro
AU - Lane, Peter L.
AU - Sorondo, Barbara
AU - Giráldez, Ediza M.
PY - 2006
Y1 - 2006
N2 - Introduction: The importance of accessing care within the first hour after injury has been a fundamental tenet of trauma system planning for 30 years. However, the scientific basis for this belief either has been missing or largely derived from case series from trauma centers. This study sought to determine the correlation between prehospital times and outcomes among severely injured elderly patients. Methods: This is a cross-sectional, observational study. All adults (<18 years of age) with acute trauma as defined by The International Classification of Diseases Ninth Edition, Clinical Modification diagnostic codes and E-codes were included. Poisonings, single system burns, and late effects of injury were excluded. Chi-square and Student's ttest were used for significance testing. To assess the predictive effects of prehospital time and outcomes, three inde-pendent logistic regression models were constructed for both young and elderly groups, with hospital length of stay, mortality, and complications as individual dependent variables. Statistical significance was set at the 0.05 level. Results: Of 41,041 cases, 37,276 were ≥18 years of age. Of the 1,866 with an Injury Severity Score (ISS) >15, 1,205 were young and 661 elderly. Logistic regression results showed that prehospital time correlated significantly with hospital length of stay (p = 0.001) and complications (p = 0.016), but not with mortality (p = 0.264) among young patients, whereas in the elderly group prehospital time had no significant predictive effect for length of stay, complications, or mortality (p = 0.512, p = 0.512, and p = 0.954 respectively). Conclusion: This population-based study has demonstrated that prehospital time correlates with length of stay and complications in young patients. In elderly patients, prehospital time failed to show correlation with any outcomes measured.
AB - Introduction: The importance of accessing care within the first hour after injury has been a fundamental tenet of trauma system planning for 30 years. However, the scientific basis for this belief either has been missing or largely derived from case series from trauma centers. This study sought to determine the correlation between prehospital times and outcomes among severely injured elderly patients. Methods: This is a cross-sectional, observational study. All adults (<18 years of age) with acute trauma as defined by The International Classification of Diseases Ninth Edition, Clinical Modification diagnostic codes and E-codes were included. Poisonings, single system burns, and late effects of injury were excluded. Chi-square and Student's ttest were used for significance testing. To assess the predictive effects of prehospital time and outcomes, three inde-pendent logistic regression models were constructed for both young and elderly groups, with hospital length of stay, mortality, and complications as individual dependent variables. Statistical significance was set at the 0.05 level. Results: Of 41,041 cases, 37,276 were ≥18 years of age. Of the 1,866 with an Injury Severity Score (ISS) >15, 1,205 were young and 661 elderly. Logistic regression results showed that prehospital time correlated significantly with hospital length of stay (p = 0.001) and complications (p = 0.016), but not with mortality (p = 0.264) among young patients, whereas in the elderly group prehospital time had no significant predictive effect for length of stay, complications, or mortality (p = 0.512, p = 0.512, and p = 0.954 respectively). Conclusion: This population-based study has demonstrated that prehospital time correlates with length of stay and complications in young patients. In elderly patients, prehospital time failed to show correlation with any outcomes measured.
KW - out-of-hospital time
KW - outcomes
KW - prehospital
KW - time
KW - trauma
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U2 - 10.1017/S1049023X00004143
DO - 10.1017/S1049023X00004143
M3 - Article
C2 - 17334190
AN - SCOPUS:33947601837
SN - 1049-023X
VL - 21
SP - 427
EP - 430
JO - Prehospital and Disaster Medicine
JF - Prehospital and Disaster Medicine
IS - 6
ER -