The Association of Limited English Proficiency With Morbidity and Mortality After Trauma.
The Association of Limited English Proficiency With Morbidity and Mortality After Trauma.
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英语能力有限与创伤后发病率和死亡率协会。
DOI：
10.1016/j.jss.2022.07.044
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Bongiovanni,Tasce
中科院分区：
文献类型：
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作者：
Castro,MariaRH;Schwartz,Hope;Hernandez,Sophia;Calthorpe,Lucia;Fernández,Alicia;Stein,Deborah;Mackersie,RobertC;Menza,Rebecca;Bongiovanni,Tasce
介绍创伤性损伤后的种族/民族和保险状况的差异是有据可查的。然而，有限的英语水平（LEP）和创伤后的结果之间的关系知之甚少。这项研究描述了LEP和发病率和死亡率之间的关联创伤injuries.MethodsA回顾性队列研究进行了一级创伤中心收治的成人创伤患者从2012年至2018年。发病率使用单变量和多变量logistic和广义线性模型控制患者人口统计学，比较LEP和英语熟练（EP）患者的住院时间（LOS）、重症监护室入院时间、重症监护室LOS、出院目的地）和住院死亡率（年龄、性别、人种/种族、保险）和临床特征（机制、激活水平、格拉斯哥昏迷评分、损伤严重度评分、创伤性脑损伤）。LEP语言包括中文（44%）和西班牙语（38%），18%被归类为“其他”，包括33种语言。在多变量模型中，LEP与医院LOS增加（P= 0.003）和出院回家与家庭健康服务（P= 0.042）或专业护理设施/康复（P= 0.006）增加统计学显著相关。LEP的死亡率为7%，EP为4%（P< 0.0001）。在多变量分析中，说LEP语言以外的中国或西班牙语是统计学显着相关的死亡率增加EP相比（P= 0.006）。ConclusionsAfter创伤性损伤，LEP患者的经验增加医院LOS和更频繁地出院回家与家庭健康服务或熟练的护理设施/康复。与EP患者相比，说汉语或西班牙语以外语言的LEP患者的死亡率增加。
IntroductionDisparities following traumatic injury by race/ethnicity and insurance status are well-documented. However, the relationship between limited English proficiency (LEP) and outcomes after trauma is poorly understood. This study describes the association between LEP and morbidity and mortality after traumatic injury.MethodsA retrospective cohort study was conducted of adult trauma patients admitted to a level 1 trauma center from 2012 to 2018. Morbidity (length of stay [LOS], intensive care unit admission, intensive care unit LOS, discharge destination) and in-hospital mortality for LEP and English proficient (EP) patients were compared using univariate and multivariable logistic and generalized linear models controlling for patient demographics (age, sex, race/ethnicity, insurance) and clinical characteristics (mechanism, activation level, Glasgow Coma Scale, Injury Severity Score, traumatic brain injury).ResultsOf the 13,104 patients, 16% were LEP patients. LEP languages included Chinese (44%) and Spanish (38%), and 18% categorized as “Other,” including 33 languages. In multivariable models, LEP was statistically significantly associated with increased hospital LOS (P= 0.003) and increased discharge to home with home health services (P= 0.042) or to skilled nursing facility/rehabilitation (P= 0.006). Mortality rate was 7% for LEPversus4% for EP patients (P< 0.0001). In multivariable analysis, speaking an LEP language other than Chinese or Spanish was statistically significantly associated with increased mortality compared to EP (P= 0.006).ConclusionsFollowing traumatic injury, LEP patients experience increased hospital LOS and are more frequently discharged to home with home health services or to skilled nursing facilities/rehabilitation. LEP patients speaking languages other than Chinese or Spanish experience increased mortality compared to EP patients.