Excess Mortality, Length of Stay, and Costs Associated with Serious Hemorrhage among Trauma Patients: Findings from the National Trauma Data Bank®
Excess Mortality, Length of Stay, and Costs Associated with Serious Hemorrhage among Trauma Patients: Findings from the National Trauma Data Bank®
复制标题
创伤患者严重出血的超额死亡率、住院时间和费用：来自国家创伤数据库®的调查结果
DOI：
10.1177/000313480707301217
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
M. Russell
中科院分区：
文献类型：
--
作者：
L. Boulanger;A. Joshi;B. Tortella;J. Menzin;John P. Caloyeras;M. Russell
创伤是暴力或碰撞对身体造成的严重伤害或休克，是一种重要且不断增长的全球健康风险。利用2000年至2004年的综合创伤登记数据，我们估计了美国创伤中心收治的患者中严重钝性和穿透性创伤相关出血的患病率，以及住院死亡率、住院时间和住院费用。我们的分析包括65，750例钝性创伤患者和12，992例穿透性创伤患者。在遭受钝性创伤的患者中，7.6%有严重出血;遭受穿透性创伤的患者中，18.8%有严重出血。严重出血患者的住院死亡率明显高于非严重出血患者（钝性出血为24.9%对8.4%;穿透性出血为23.4%对4.2%）（P <0.05）。严重出血患者的校正后平均超额住院时间为钝性创伤0.4天，穿透性创伤2.7天（P <0.05）;校正后的超额费用为钝性创伤患者每天296美元，穿透性创伤患者每天637美元（P <0.05）。在钝性和穿透性创伤病例中，严重出血与死亡率过高、住院时间延长和费用增加显著相关。
Trauma is a serious injury or shock to the body from violence or crash and is an important and growing global health risk. Using 2000 to 2004 data from a comprehensive trauma registry, we estimated the prevalence of serious blunt and penetrating trauma-related hemorrhage among patients admitted to U.S. trauma centers along with excess in-hospital mortality, length of hospital stay, and inpatient costs. There were 65,750 patients with blunt trauma and 12,992 patients with penetrating trauma included in our analyses. Of patients sustaining blunt trauma, 7.6 per cent had serious hemorrhage; 18.8 per cent of patients sustaining penetrating trauma had serious hemorrhage. In-hospital mortality rates were significantly (P < 0.05) higher for patients with serious hemorrhage than for patients without (24.9 per cent versus 8.4 per cent for blunt; 23.4 per cent versus 4.2 per cent for penetrating). Patients with serious hemorrhage had adjusted mean excess lengths of stay of 0.4 days for blunt trauma and 2.7 days for penetrating trauma (P < 0.05); adjusted excess costs were $296 per day for patients sustaining blunt trauma and $637 per day for patients sustaining penetrating trauma (P < 0.05). In both blunt and penetrating trauma cases, serious hemorrhage is significantly associated with excess mortality, longer hospital stays, and higher costs.