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The impact of emergency department length of stay on the outcomes of trauma patients requiring hospitalization: a retrospective observational study

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World Journal of Emergency Medicine 2023年第2期14卷 96-105页

作者： Ahmed Faidh Ramzee Ayman El-Menyar Mohammad Asim Ahad Kanbar Khalid Ahmed Bahaa Daoud saji mathradikkal Ahmad Kloub Hassan Al-Thani Sandro Rizoli Trauma Surgery Section Hamad General Hospital(HGH)Doha P.O Box 3050Qatar Clinical Research Trauma&Vascular Surgery SectionHGHDoha P.O Box 3050Qatar Clinical Medicine Weill Cornell Medical CollegeDoha P.O Box 3050Qatar

BACKGROUND: We aimed to explore the impact of the emergency department length of stay(EDLOS) on the outcome of trauma ***: A retrospective study was conducted on all trauma patients requiring hospitalization between 2015 and 2019. Patients were categorized into 4 groups based on the EDLOS(24 h). Data were analyzed using Chi-square test(categorical variables), Student’s t-test(continuous variables), correlation coefficient, analysis of variance and multivariate logistic regression analysis for identifying predictors of short EDLOS and hospital ***: The study involved 7,026 patients with a mean age of 32.1±15.6 years. Onefifth of patients had a short EDLOS(24 h were older(P=0.001) and had more comorbidities(P=0.001) and fewer deaths(P=0.001). Multivariate regression analysis showed that the predictors of short EDLOS were female gender, GCS, SI, hemoglobin level, ISS, and blood transfusion. The predictors of mortality were TTA-1(odds ratio [OR]=4.081, 95%CI: 2.364–7.045), head injury(OR=3.920, 95%CI: 2.413–6.368), blood transfusion(OR=2.773, 95%CI: 1.668–4.609), SI(OR=2.132, 95%CI: 1.364–3.332), ISS(OR=1.077, 95%CI: 1.057–1.096), and age(OR=1.040, 95%CI: 1.026–1.054). CONCLUSIONS: Patients with shorter EDLOS had different baseline characteristics and hospital outcomes compared with patients with longer EDLOS. Patients with prolonged EDLOS had better outcomes;however, the burden of prolonged boarding in the ED needs further elaboration.

关键词： Emergency department Length of stay Trauma Management Outcomes Trauma activation criteria

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Delta shock index predicts injury severity,interventions,and outcomes in trauma patients:A 10-year retrospective observational study

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World Journal of Critical Care Medicine 2024年第4期13卷 62-72页

作者： Mohammad Asim Ayman El-Menyar Khalid Ahmed Mushreq Al-Ani saji mathradikkal Abubaker Alaieb Abdel Aziz Hammo Ibrahim Taha Ahmad Kloub Hassan Al-Thani Department of Surgery Trauma and Vascular Surgery SectionClinical ResearchHamad Medical CorporationDoha 3050Qatar Department of Clinical Medicine Weill Cornell MedicinePO Box 24144DohaQatar Department of Surgery Trauma Surgery SectionHamad Medical CorporationDoha 3050Qatar

BACKGROUND Most trauma occurs among young male subjects in *** examined the predictive values of the delta shock index(DSI),defined as the change in the shock index(SI)value from the scene to the initial reading in the emergency unit(i.e.,subtracting the calculated SI at admission from SI at the scene),at a Level 1 trauma *** To explore whether high DSI is associated with severe injuries,more interventions,and worse outcomes[i.e.,blood transfusion,exploratory laparotomy,ventilator-associated pneumonia,hospital length of stay(HLOS),and in-hospital mortality]in trauma *** A retrospective analysis was conducted after data were extracted from the National Trauma Registry between 2011 and *** were grouped based on DSI as low(≤0.1)or high(>0.1).Data were analyzed and compared usingχ^(2) and Student’s *** between DSI and injury severity score(ISS),revised trauma score(RTS),abbreviated injury scale(AIS),Glasgow coma scale(GCS),trauma score-ISS(TRISS),HLOS,and number of transfused blood units(NTBU),were assessed using correlation coefficient *** diagnostic testing accuracy for predicting mortality was determined using the validity measures of the *** regression analysis was performed to identify predictors of *** This analysis included 13212 patients with a mean age of 33±14 years,and 24%had a high *** accounted for 91%of the study *** trauma activation level was higher in patients with a high DSI(38%vs 15%,P=0.001).DSI correlated with RTS(r=-0.30),TRISS(r=-0.30),NTBU(r=0.20),GCS(r=-0.24),ISS(r=0.22),and HLOS(r=0.14)(P=0.001 for all).High DSI was associated with significantly higher rates of intubation,laparotomy,ventilator-associated pneumonia,massive transfusion activation,and mortality than low *** mortality prediction,a high DSI had better specificity,negative predictive value,and negative likelihood ratio(77%,99%,and 0.49%,respectively).After adjusting for age,emerge

关键词： Delta shock index Trauma Injury severity scores Interventions Outcomes

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