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Mortality of trauma...
Mortality of trauma patients treated at trauma centers compared to non-trauma centers in Sweden: a retrospective study
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- Candefjord, Stefan, 1981 (författare)
- Chalmers tekniska högskola,Chalmers University of Technology
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- Asker, Linn (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery,Sahlgrenska universitetssjukhuset,Sahlgrenska University Hospital
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- Caragounis, Eva Corina (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för kirurgi,Institute of Clinical Sciences, Department of Surgery,Sahlgrenska universitetssjukhuset,Sahlgrenska University Hospital
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(creator_code:org_t)
- 2020-07-27
- 2022
- Engelska.
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Ingår i: European Journal of Trauma and Emergency Surgery. - : Springer Science and Business Media LLC. - 1863-9933 .- 1863-9941 .- 1615-3146. ; 48, s. 525-536
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Abstract
Ämnesord
Stäng
- Objective The main objective was to compare the 30-day mortality rate of trauma patients treated at trauma centers as compared to non-trauma centers in Sweden. The secondary objective was to evaluate how injury severity influences the potential survival benefit of specialized care. Methods This retrospective study included 29,864 patients from the national Swedish Trauma Registry (SweTrau) during the period 2013-2017. Three sampling exclusion criteria were applied: (1) Injury Severity Score (ISS) of zero; (2) missing data in any variable of interest; (3) data falling outside realistic values and duplicate registrations. University hospitals were classified as trauma centers; other hospitals as non-trauma centers. Logistic regression was used to analyze the effect of trauma center care on mortality rate, while adjusting for other factors potentially affecting the risk of death. Results Treatment at a trauma center in Sweden was associated with a 41% lower adjusted 30-day mortality (odds ratio 0.59 [0.50-0.70],p < 0.0001) compared to non-trauma center care, considering all injured patients (ISS >= 1). The potential survival benefit increased substantially with higher injury severity, with up to > 70% mortality decrease for the most critically injured group (ISS >= 50). Conclusions There exists a potentially substantial survival benefit for trauma patients treated at trauma centers in Sweden, especially for the most severely injured. This study motivates a critical review and possible reorganization of the national trauma system, and further research to identify the characteristics of patients in most need of specialized care.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Allmänmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- General Practice (hsv//eng)
Nyckelord
- Trauma
- Triage
- Trauma center
- Trauma system
- Mortality
- SweTrau
- injury severity score
- major trauma
- center designation
- undertriage
- transport
- system
- adherence
- protocol
- deaths
- Emergency Medicine
- Trauma center
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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