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Factors associated with death in the emergency department for trauma incidents
Data from the Indiana Patient Registry were pulled for all trauma cases in Indiana from January 1, 2013 through June 30, 2014. Logistic regression was modeled on emergency department (ED) disposition as the outcome variable (“Expired” or “Not Expired”) and age, race, gender, alcohol use, trauma type and trauma center status were the independent variables. Alcohol use, trauma type and trauma center status are the variables of interest; age race and gender were controlled for in the model.
There were 42,745 trauma incidents where emergency department disposition was ‘Expired’ or ‘Not Expired.’ Gender, trauma type and alcohol were statistically significant and age approached statistical significance.
Trauma incidents that experienced ‘Other trauma type’ have 1.6 times the odds of expiring in the ED compared to ‘Blunt trauma type.’ Trauma incidents with ‘Penetrating trauma type’ have 6.73 times the odds of expiring in the ED compared to ‘Blunt trauma type’. Trauma incidents where alcohol consumption was ‘Not Known/Nor Recorded/Not Applicable’ had 0.99 times the odds of expiring in the ED compared to those with no alcohol consumption. Trauma incidents where alcohol was consumed had 0.46 the odds of expiring in the ED compared to those with no alcohol consumption.
There were 333 trauma incidents from January 1, 2013 to June 30, 2014 that resulted in death in the emergency department. Patients that experienced other trauma type or penetrating trauma were more likely to die than those that had blunt trauma. Alcohol was a protective factor against death.
Further research with larger sample sizes could focus on factors related to emergency department outcomes other than the dichotomous expired versus not expired. Larger sample sizes would also increase power to detect significance for interaction effects
Learning Areas:
EpidemiologyPublic health or related research
Learning Objectives:
Identify risk factors associated with an increased risk of expiring in the ED for trauma patients.
Describe the effect of alcohol consumption on the risk of dying in the ED.
Keyword(s): Epidemiology, Hospitals
Qualified on the content I am responsible for because: I have an MPH degree and I work in trauma and injury prevention. Among my scientific interests has been factors impacting trauma and injury outcomes.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.