Outcomes and costs of blunt trauma in England and Wales

Christensen, Michael Cronquist; Ridley, S.; Lecky, Fiona; Munro, Vicki; Morris, Stephen

doi:10.1186/cc6797

Cited by 64 publications

(50 citation statements)

References 9 publications

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“…Over 90% of injuries were alleged assaults. The median (interquartile range [IQR]) GCS was 15 across the whole sample, falling to 8 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14) in the ISS 35-75 group. Mean (95% confidence interval [CI]) systolic blood pressure in A&E was 124 mmHg (122-126) and mean pulse rate was 94 beats per minute (92-95).…”

Section: Sample Characteristicsmentioning

confidence: 99%

Outcomes and costs of penetrating trauma injury in England and Wales

Christensen

Nielsen

Ridley

et al. 2008

Injury

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SummaryBackground: Penetrating trauma injury is generally associated with higher short-term mortality than blunt trauma, and results in substantial societal costs given the young age of those typically injured. Little information exists on the patient and treatment characteristics for penetrating trauma in England and Wales, and the acute outcomes and costs of care have not been documented and analysed in detail. Methods: Using the Trauma Audit Research Network (TARN) database, we examined patient records for persons aged 18+ years hospitalised for penetrating trauma injury between January 2000 and December 2005. Patients were stratified by injury severity score (ISS). Results: 1365 patients were identified; 16% with ISS 1-8, 50% ISS 9-15, 15% ISS 1624, 16% ISS 25-34, and 4% with ISS 35-75. The median age was 30 years and 91% of patients were men. Over 90% of the injuries occurred in alleged assaults. Stabbings were the most common cause of injury (73%), followed by shootings (19%). Forty-seven percent were admitted to critical care for a median length of stay of 2 days; median total hospital length of stay was 7 days. Sixty-nine percent of patients underwent at least one surgical procedure. Eight percent of the patients died before discharge, with a mean time to death of 1.6 days (S.D. 4.0). Mortality ranged from 0% among patients with ISS 1-8 to 55% in patients with ISS > 34. The mean hospital cost per patient was £7983, ranging from £6035 in patients with ISS 9-15 to £16,438 among patients with ISS > 34. Costs varied significantly by ISS, hospital mortality, cause and body region of injury. Conclusion: The acute treatment costs of penetrating trauma injury in England and Wales vary by patient, injury and treatment characteristics. Measures designed to reduce the incidence and severity of penetrating trauma may result in significant hospital cost savings.

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Section: Sample Characteristicsmentioning

confidence: 99%

Outcomes and costs of penetrating trauma injury in England and Wales

Christensen

Nielsen

Ridley

et al. 2008

Injury

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“…The median total hospital length of stay was 9 days, and 69% of patients underwent at least one surgical procedure. 10 In study by Youssef Saleh et al the mean hospital stay was 19.42 days in 60% of the cases and 34 days in rest 40% of the patients. 4 …”

Section: Resultsmentioning

confidence: 93%

Management and outcome in patients with below knee soft tissue injuries

Sachdev¹,

Rajan²,

Dvivedi³

et al. 2018

Int Surg J

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Background: Treatment of lower limb injuries pose a great challenge. Debridement is the key to success in the management of major limb injuries followed by soft-tissue coverage in the form of suturing, skin grafts, or flaps. Our aim is to study the management of various below knee soft tissue injuries.Methods: The study was conducted in the Department of Surgery, Himalayan Institute of Medical Sciences (HIMS), Swami Ram Nagar, Dehradun, over a period of 12 months. Subjects were recruited from patients presenting in Emergency/Surgery OPD, HIMS, Dehradun with a primary diagnosis of below knee soft tissue injuries. A total of 64 patients were included in the study.Results: Primary closure was done in 6 wounds and coverage in rest, with maximum in the form of split skin graft. Abrasion wounds were managed without any surgical intervention. Reconstructive surgery was performed two or more times in 39.06% patients. Local complications were seen in 23.43% of patients and general complications AKI and Tetanus in 2patients.68.75% of patients with local complications were observed to have contaminated wound status at the time of presentation. The average duration of hospital stays ranged between 3 to 56 days. Majority of the patients were discharged within 1 to 3 weeks with mean duration of hospital stay being 17.82±10.95 days.Conclusions: Proper debridement, early coverage of wounds and prompt identification and management of complications is the key to success in the management of lower limb trauma.

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“…In a systematic review of costutilization studies in trauma (adult and pediatric), Willenberg and colleagues 15 reported a median per-patient cost of $22 448 for the treatment of acute trauma. Despite the variability among the studies included in the review, the presence and type of surgery 16,17 and higher ISS 7 independently predicted increased cost. The higher hospitalization costs observed in our study, therefore, are not surprising, given that we focused on surgical trauma patients, who had higher ISS than their nonsurgical counterparts.…”

Section: Discussionmentioning

confidence: 99%

Surgical intervention in pediatric trauma at a level 1 trauma hospital: a retrospective cohort study and report of cost data

Anantha

Zamiara

Merritt

2018

cjs

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Background: Given that the management of severely injured children requires co ordinated care provided by multiple pediatric surgical subspecialties, we sought to describe the frequency and associated costs of surgical intervention among pediatric trauma patients admitted to a level 1 trauma centre in southwestern Ontario.Methods: All pediatric (age < 18 yr) trauma patients treated at the Children's Hospital -London Health Sciences Centre (CH-LHSC) between 2002 and 2013 were included in this study. We compared patients undergoing surgical intervention with a nonsurgical group with respect to demographic characteristics and outcomes. Hospitalassociated costs were calculated only for the surgical group.Results: Of 784 injured children, 258 (33%) required surgery, 40% of whom underwent orthopedic interventions. These patients were older and more severely injured, and they had longer lengths of stay than their nonsurgical counterparts. There was no difference in mortality between the groups. Seventy-four surgical patients required intervention within 4 hours of admission; 45% of them required neurosurgical intervention. The median cost of hospitalization was $27 571 for the surgical group. Conclusion:One-third of pediatric trauma patients required surgical intervention, of whom one-third required intervention within 4 hours of arrival. Despite the associated costs, the surgical treatment of children was associated with comparable mortality to nonsurgical treatment of less severely injured patients. This study represents the most recent update to the per patient cost for surgically treated pediatric trauma patients in Ontario, Canada, and helps to highlight the multispecialty care needed for the management of injured children.Contexte : La prise en charge des enfants grièvement blessés nécessite la coordination des soins fournis dans le contexte de plusieurs surspécialités chirurgicales pédia-triques. Dans ce contexte, nous avons cherché à décrire la fréquence et les coûts des interventions chirurgicales chez les patients pédiatriques victimes de trauma admis dans un centre de traumatologie de niveau 1 dans le sud-ouest de l'Ontario.

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Outcomes and costs of blunt trauma in England and Wales

Cited by 64 publications

References 9 publications

Outcomes and costs of penetrating trauma injury in England and Wales

Outcomes and costs of penetrating trauma injury in England and Wales

Management and outcome in patients with below knee soft tissue injuries

Surgical intervention in pediatric trauma at a level 1 trauma hospital: a retrospective cohort study and report of cost data

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