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Interhospital transfer of liver trauma in New Mexico: a state of austere resources.
Szoka, Nova; Murray-Krezan, Cristina; Miskimins, Richard; Greenbaum, Alissa; Tobey, David; Faizi, Syed; West, Sonlee; Lu, Stephen; Howdieshell, Thomas; Demarest, Gerald; Nir, Itzhak.
Afiliação
  • Szoka N; Department of Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico.
  • Murray-Krezan C; Division of Epidemiology, Biostatistics, and Preventive Medicine, Department of Internal Medicine, University of New Mexico Health Sciences Center, Albuquerque, New Mexico.
  • Miskimins R; Department of Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico.
  • Greenbaum A; Department of Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico.
  • Tobey D; Department of Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico.
  • Faizi S; Department of Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico.
  • West S; Department of Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico.
  • Lu S; Department of Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico.
  • Howdieshell T; Department of Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico.
  • Demarest G; Department of Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico.
  • Nir I; Department of Surgery, University of New Mexico School of Medicine, Albuquerque, New Mexico. Electronic address: inir@salud.unm.edu.
J Surg Res ; 191(1): 25-32, 2014 Sep.
Article em En | MEDLINE | ID: mdl-24990540
BACKGROUND: There is debate in the trauma literature regarding the effect of prolonged prehospital transport on morbidity and mortality. This study analyzes the management of hepatic trauma patients requiring surgery and compares the outcomes of the group that was transferred to the University of New Mexico Hospital (UNMH) from outside institutions, to the directly admitted group. MATERIALS AND METHODS: The UNMH Trauma Database was queried from 2005-2012. Of 674 patients who sustained liver injuries, 163 required surgery: 46 patients (28.2%) underwent interhospital transfer, and 117 (71.8%) were directly admitted. Variables examined included transfer status, trauma mechanism, transport type, injury severity score (ISS), liver injury grade, and associated injuries. Outcome variables included length of stay (LOS) and 30-day mortality. Outcomes of the transfer group (TG) and direct admit group (DAG) were compared. RESULTS: Both TG and DAG had the same median age (31 y, P = 0.33). The blunt-to-penetrating ratio was the same for each group (48% blunt: 52% penetrating, P = 1.0). Median ISS was 25 for the TG and 26 for the DAG. Grade III or higher injury occurred in 29 (63%) of the TG and in 68 (58%) of the DAG (P = 0.56). Median hospital LOS was 14 d for TG and 9 d for DAG (P = 0.15). Median intensive care unit LOS was 4 d for both groups (P = 0.71). Thirty-day mortality was 20% in each group (P = 0.27). Using a multiple logistic regression model for the outcome of mortality, only age, ISS, and liver injury grade, not transfer status or transport type, had a significant effect on mortality. CONCLUSIONS: There was no significant difference in liver injury grade, ISS, LOS, and mortality between TG and DAG. In the patient population of our study, transfer status did not affect outcome.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ferimentos não Penetrantes / Transferência de Pacientes / Alocação de Recursos / Traumatismos Abdominais / Fígado Tipo de estudo: Prognostic_studies Limite: Adult / Female / Humans / Male País/Região como assunto: America do norte / Mexico Idioma: En Revista: J Surg Res Ano de publicação: 2014 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Ferimentos não Penetrantes / Transferência de Pacientes / Alocação de Recursos / Traumatismos Abdominais / Fígado Tipo de estudo: Prognostic_studies Limite: Adult / Female / Humans / Male País/Região como assunto: America do norte / Mexico Idioma: En Revista: J Surg Res Ano de publicação: 2014 Tipo de documento: Article País de publicação: Estados Unidos