MARC details
| 000 -LEADER |
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| fixed length control field |
02535cam a2200265 4500 |
| 100 1# - MAIN ENTRY--PERSONAL NAME |
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| Personal name |
CHIU William C |
| 245 ## - TITLE STATEMENT |
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| Title |
Impact of trauma centre capacity and volume on the mortality risk of incoming new admissions/ |
| Statement of responsibility, etc. |
William C Chiu, D B Powers, J M Hirshon et.al |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. |
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| Date of publication, distribution, etc. |
2022 |
| 520 ## - SUMMARY, ETC. |
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| Summary, etc. |
Introduction: Trauma centre capacity and surge volume may affect decisions on where to transport a critically injured patient and whether to bypass the closest facility. Our hypothesis was that overcrowding and high patient acuity would contribute to increase the mortality risk for incoming admissions. |
| 520 ## - SUMMARY, ETC. |
|---|
| Summary, etc. |
Methods: For a 6-year period, we merged and cross-correlated our institutional trauma registry with a database on Trauma Resuscitation Unit (TRU) patient admissions, movement and discharges, with average capacity of 12 trauma bays. The outcomes of overall hospital and 24hours mortality for new trauma admissions (NEW) were assessed by multivariate logistic regression. |
| 520 ## - SUMMARY, ETC. |
|---|
| Summary, etc. |
Results: There were 42003 (mean=7000/year) admissions having complete data sets, with 36354 (87%) patients who were primary trauma admissions, age ≥18 and survival ≥15min. In the logistic regression model for the entire cohort, NEW admission hospital mortality was only associated with NEW admission age and prehospital Glasgow Coma Scale (GCS) and Shock Index (SI) (all p<0.05). When TRU occupancy reached ≥16 patients, the factors associated with increased NEW admission hospital mortality were existing patients (TRU >1hour) with SI ≥0.9, recent admissions (TRU ≤1hour) with age ≥65, NEW admission age and prehospital GCS and SI (all p<0.05). |
| 520 ## - SUMMARY, ETC. |
|---|
| Summary, etc. |
Conclusion: The mortality of incoming patients is not impacted by routine trauma centre overcapacity. In conditions of severe overcrowding, the number of admitted patients with shock physiology and a recent surge of elderly/debilitated patients may influence the mortality risk of a new trauma admission. |
| 598 ## - BULLETIN HEADING |
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| Bulletin Heading |
MILITARY, HEALTH |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Topical term or geographic name entry element |
TRAUMA CARE |
| General subdivision |
TIME-CRITICAL ASSESSMENTS |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
TRAUMA SYSTEMS |
| General subdivision |
CRITICAL INJURED |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
TRAUMA CENTRE CAPACITY |
| -- |
SURGE VOLUME |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
GLASGOW COMA SCALE |
| -- |
SHOCK INDEX |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
MORTALITY INCOMING PATIENTS |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
|---|
| Topical term or geographic name entry element |
MILITARY |
| General subdivision |
HEALTH |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
|---|
| Personal name |
POWERS D B |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
|---|
| Personal name |
HIRSHON J M |
| 773 ## - HOST ITEM ENTRY |
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| Main entry heading |
BMJ Military Health: |
| Related parts |
Vol.168, Iss.3, June 2022, pp.212-217 (37) |
| 856 ## - ELECTRONIC LOCATION AND ACCESS |
|---|
| Uniform Resource Identifier |
<a href="https://militaryhealth.bmj.com/content/168/3/212">https://militaryhealth.bmj.com/content/168/3/212</a> |
| Public note |
Click here for more |
| 945 ## - LOCAL PROCESSING INFORMATION (OCLC) |
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| i |
67738.1001 |
| r |
Y |
| s |
Y |
