Socioeconomic disparities in the thoracic trauma population

Haines, Krista; Zens, Tiffany; Beems, Megan; Rauh, Ryan; Jung, Hee Soo; Agarwal, Suresh

doi:10.1016/j.jss.2017.11.071

Cited by 18 publications

(21 citation statements)

References 31 publications

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“…TT is considered a globally neglected disease and, besides being a financial hindrance to public health, it is also an economic and social welfare problem, since it involves mainly young adults, and is a significant cause of morbimortality and incapacity among the economically active population 19 . We can notice in medical literature a similarity of profiles in TT victims, regarding gender and age that are mostly striken 4,[20][21][22][23] . This data suggests that men are more exposed to traumatic 28 which shows that cases with a greater potential for morbimortality were cared for precociously.…”

Section: Discussionmentioning

confidence: 99%

Perfil epidemiológico do trauma torácico em um hospital referência da Foz do Rio Itajaí.

Zanette

Waltrick

Monte

2019

Rev. Col. Bras. Cir.

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RESUMO Objetivo: descrever o perfil epidemiológico do trauma torácico na região da Foz do Rio Itajaí, no Estado de Santa Catarina, Brasil. Métodos: estudo observacional, descritivo e prospectivo, realizado através de coleta de dados a partir de formulário pré-elaborado pelos pesquisadores e preenchido pela equipe responsável pelo atendimento em hospital de referência, entre junho de 2017 e maio de 2018. Resultados: foram analisados 119 formulários de pacientes vítimas de trauma torácico, dos quais 70,5% eram homens e 29,4% mulheres, com média de idade de 39,8 anos. Os atendimentos ocorreram geralmente no período diurno (67,9%), 30,2% dos pacientes chegaram ao serviço através de meios próprios e 52,9% após uma hora do trauma. Quanto aos exames admissionais, a maior parte das vítimas foi submetida exclusivamente à radiografia de tórax (67,2%). Houve prevalência de trauma torácico fechado (89%), tendo como principal mecanismo os acidentes com motocicleta (35,2%) e a lesão predominante foi a fratura de costela (42%). A maioria dos pacientes (53,8%) foi submetida a tratamento conservador. O tempo médio de internação foi de 2,6 dias e a taxa de óbito de 5%. Conclusão: o perfil dos pacientes com trauma torácico em Itajaí é de homens jovens, atendidos durante o dia, a maioria com fratura de costela, acometidos por trauma torácico fechado em decorrência de acidente de trânsito envolvendo motocicleta. A radiografia de tórax foi utilizada para a confirmação de grande parte dos diagnósticos e houve prevalência de tratamento conservador. O tempo de internação e taxa de óbito foram menores do que na literatura, o que pode ser explicado pelo alto índice de lesão muscular exclusiva.

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Section: Discussionmentioning

confidence: 99%

Perfil epidemiológico do trauma torácico em um hospital referência da Foz do Rio Itajaí.

Zanette

Waltrick

Monte

2019

Rev. Col. Bras. Cir.

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“…While we demonstrated an association between low SES and larger thyroid volume, causality may be more complex. 8,10,13,14 An additional limitation is that our study is restricted to a single-institution with a relatively small number of subjects. Low SES has been associated with limited access to health care 33 because of lack of insurance and/or inability to obtain services, 6 factors which may be present among our population.…”

Section: Discussionmentioning

confidence: 99%

“…In our concentrated urban population, insurance status was an available and measureable marker of SES, which has been previously validated for use in examining disparities in presentation and outcome of disease. 8,10,13,14 An additional limitation is that our study is restricted to a single-institution with a relatively small number of subjects. However, given the lack of existing literature on this topic and the robust nature of our multivariable analyses, we feel these limitations are acceptable.…”

Section: Discussionmentioning

confidence: 99%

“…8,10,13,14 We concurrently evaluated demographic and clinical variables known to influence the presentation of thyroid volume, as a measure of benign thyroid disease. Insurance status was an available and measureable marker of SES in our concentrated urban population and is consistent with methodology used in prior studies.…”

Section: Introductionmentioning

confidence: 99%

“…Insurance status was an available and measureable marker of SES in our concentrated urban population and is consistent with methodology used in prior studies. 8,10,13,14 We concurrently evaluated demographic and clinical variables known to influence the presentation of thyroid volume, as a measure of benign thyroid disease. 11,12 To our knowledge, this is the first study to examine the association between insurance status and whole thyroid volume, utilizing pathologic volumes as a measure of disease burden.…”

Section: Introductionmentioning

confidence: 99%

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Socioeconomic disparities in a population of patients undergoing total thyroidectomy for benign disease

El‐Sayed

et al. 2018

Head & Neck

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Background This study examines the effect of insurance status (as a measure of socioeconomic status) on patient with benign thyroid disease. Methods A retrospective review was performed among 60 patients undergoing total thyroidectomy for benign thyroid disease. Univariate and multivariable analyses examined the relationship between insurance status and thyroid volume (sum of the left and right lobe volumes). Results Twenty‐eight (47%) patients were considered of underinsured/uninsured status, and 32 (53%) patients were considered of private/government/military insurance status. Median pathologic whole thyroid volume was 66 mL (range, 2‐855). After multivariable linear regression, underinsured/uninsured status was the only significant predictor of larger volume (correlation coefficient [r] = 118; 95% CI, 42 to 194; P = .003), after adjusting for age, sex, body mass index, and presence of concomitant thyroid disease and compressive symptoms. Conclusion Patients of underinsured/uninsured status suffered more severe disease presentations at time of thyroidectomy, as measured by larger thyroid volumes.

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Chest Trauma Outcomes: Public Versus Private Level I Trauma Centers

et al. 2020

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Background The goal of our study was to evaluate the differences in care and clinical outcomes of patients with chest trauma between two hospitals, including one public trauma center (Pu-TC) and one private trauma center (Pri-TC). Methods Patients with thoracic trauma admitted from January 2012 to December 2018 at two level I trauma centers (Pu-TC: Hospital Universitario del Valle, Pri-TC: Fundacio ´n Valle del Lili) in Cali, Colombia, were included. Multivariable logistic regression was used to assess for differences in in-hospital mortality, adjusting for relevant demographic and clinical characteristics. Results A total of 482 patients were identified; 300 (62.2%) at the Pri-TC and 182 (37.8%) at the Pu-TC. Median age was 27 years (IQR 21-36) and median Injury Severity Score was 25 . 456 patients (94.6%) were male, and the majority had penetrating trauma [total 465 (96.5%); Pri-TC 287 (95.7%), Pu-TC 179 (98.4%), p 0.08]. All patients arrived at the emergency room with unstable hemodynamics. There were no statistically significant differences in post-operative complications, including retained hemothorax [Pri-TC 19 vs. Pu-TC 18], pneumonia [Pri-TC 14 vs. Pu-TC 14], empyema [Pri-TC 13 vs. Pu-TC 13] and mediastinitis [Pri-TC 6 vs. Pu-TC 2]. Logistic regression did, however, show a higher odds of mortality when patients were treated at the Pu-TC , p \ 0.001]. Conclusions Our study found significant statistical differences in clinical outcomes between patients treated at a Pu-TC and Pri-TC. The results are intended to stimulate discussions to better understand reasons for outcome variability and ways to reduce it.

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Socioeconomic disparities in the thoracic trauma population

Abstract: Level 3, economic/decision.

Cited by 18 publications

References 31 publications

Perfil epidemiológico do trauma torácico em um hospital referência da Foz do Rio Itajaí.

Perfil epidemiológico do trauma torácico em um hospital referência da Foz do Rio Itajaí.

Socioeconomic disparities in a population of patients undergoing total thyroidectomy for benign disease

Chest Trauma Outcomes: Public Versus Private Level I Trauma Centers

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