3043.0: Monday, October 22, 2001 - Board 3

Abstract #27614

Mortality in rural versus urban areas among moderately injured trauma patients

Kerrie A. Pinkney, MD, MPH1, N. Clay Mann, PhD, MS2, Donald Vernon, MD1, and J. Michael Dean, MD, MBA1. (1) Intermountain Injury Control Research Center, University of Utah, 410 Chipeta Way, Suite 222, Salt Lake City, UT 84108-1226, 801-587-7649, kerrie.pinkney@hsc.utah.edu, (2) University of Utah School of Medicine, Intermountain Injury Control Research Center, 410 Chipeta Way, Suite 222, Salt Lake City, UT 84108-9161

Objective: The purpose of this study was to examine the characteristics of trauma patients who died with Revised Trauma Scores (RTS) of > 4 treated at urban versus rural Utah hospitals. A secondary purpose is to evaluate any common characteristics among these patients since these patients generally have a good probability of survival using TRISS® methodology.

Design: Retrospective review of state trauma data (1995 – 2000) obtained from 21 Utah hospitals.

Results: Data was obtained from 22,441 records and 21 institutions (135 records had no institution listed). There were 13,573 males (60.5%) and 8861 females (39.4%). Types of trauma were: 20,182 blunt (89.9%), and 1658 penetrating (7.4%) with 601 records missing this field. Three hundred and one patients died with an RTS > 4. The mean age of the 301 patients with an RTS > 4 who died was 63.34 ± 25.22 years. The mean GCS of these patients was 11.6 ± 4.6. Three institutions in Utah are Level I equivalent and 168 of 297 deaths (56.6%) occurred at these institutions versus 129 (43.4%)at rural institutions. The mean probability of survival from blunt and penetrating trauma calculated using TRISS® methodology was 78.4 ± 26.4% and 77.9 ± 27.6%, respectively.

Conclusion: Advanced age seems to be an important factor among trauma patients with an RTS >4 who died in Utah since 1995. However, 52.4% of patients ≤ 18 years of age who died demonstrated a good probability of survival. Processes of care for these patients demonstrate areas where intervention may improve survival.

See iicrc.med.utah.edu

Learning Objectives: N/A

Keywords: Mortality, Injury

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA