Effect of pre-existing disease on length of hospital stay in trauma patients.
Effect of pre-existing disease on length of hospital stay in trauma patients.
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既往疾病对创伤患者住院时间的影响。
DOI：
10.1097/00005373-198906000-00011
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发表时间：
1989
期刊：
影响因子：
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通讯作者：
Sharon L. Edelstein
中科院分区：
文献类型：
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作者：
Ellen J. MacKenzie;John A. Morris;Sharon L. Edelstein
在五个县的地区，所有成人创伤入院（n = 27，029）的急性护理医院的出院数据被用来检查预先存在的慢性疾病（佩奇）对住院时间（LOS）的影响。平均LOS增加的百分比和延长LOS的相对几率（即，大于或等于3周），同时考虑损伤的ISS严重程度和患者年龄，对有或无11种预先存在的医疗状况中的一种或多种的幸存创伤患者进行估计。19%（n = 5，224）的创伤病例有11种佩奇中的一种或多种; 5%（n = 1，384）有两种或多种佩奇。那些有一个或多个佩奇的人比那些没有PEC的人呆得更长（p <0.001）。有PEC的患者的平均LOS比无佩奇的患者高69%。此外，有佩奇的患者住院3周或更长时间的可能性是没有佩奇的患者的两倍多。然而，影响的大小因患者年龄和损伤严重程度而异;佩奇对住院时间的影响在年轻患者和损伤不太严重的患者中更大。随着区域化，创伤中心治疗这些患者中的大多数，并且当基于DRGs报销时可能遭受不成比例的经济损失。
Hospital discharge data for all adult trauma admissions (n = 27,029) to acute care hospitals in a five-county area were used to examine the effect of pre-existing chronic conditions (PECs) on length of hospital stay (LOS). The per cent increase in mean LOS and the relative odds of an extended LOS (i.e., greater than or equal to 3 weeks) were estimated for surviving trauma patients with and without one or more of 11 pre-existing medical conditions, taking into account both the ISS severity of injuries and patient age. Nineteen per cent (n = 5,224) of the trauma cases had one or more of the 11 PECs; 5% (n = 1,384) had two or more PECs. Those with one or more PECs stayed significantly longer (p less than 0.001) than those who had none. Mean LOS was shown to be 69% higher for those with versus those without PECs. Furthermore, patients with PECs were more than twice as likely as those without PECs to have stayed in the hospital 3 weeks or longer. The size of the effect, however, varied by patient age and injury severity; the effect of PECs on length of stay was larger among younger patients and patients with less severe injuries. With regionalization, trauma centers treat the majority of these patients and potentially suffer disproportionate financial losses when reimbursement is based on DRGs.