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Impact of hospital type on risk-adjusted, traffic-related 30-day mortality: a population-based registry study
Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, ANOPIVA US.
Linköping University, Department of Biomedical and Clinical Sciences, Division of Surgery, Orthopedics and Oncology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.ORCID iD: 0000-0002-8027-9632
Life Regiment Hussars, Karlsborg, Sweden.
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2021 (English)In: Burns & Trauma, ISSN 2321-3876, Vol. 9, article id tkaa051Article in journal (Refereed) Published
Abstract [en]

Background: Traffic incidents are still a major contributor to hospital admissions and trauma-relatedmortality. The aim of this nationwide study was to examine risk-adjusted traffic injury mortality todetermine whether hospital type was an independent survival factor.

Methods: Data on all patients admitted to Swedish hospitals with traffic-related injuries, basedon International Classification of Diseases codes, between 2001 and 2011 were extracted fromthe Swedish inpatient and cause of death registries. Using the binary outcome measure of deathor survival, data were analysed using logistic regression, adjusting for age, sex, comorbidity,severity of injury and hospital type. The severity of injury was established using the InternationalClassification of Diseases Injury Severity Score (ICISS).

Results: The final study population consisted of 152,693 hospital admissions. Young individuals(0–25 years of age) were overrepresented, accounting for 41% of traffic-related injuries. Menwere overrepresented in all age categories. Fatalities at university hospitals had the lowest mean(SD) ICISS 0.68 (0.19). Regional and county hospitals had mean ICISS 0.75 (0.15) and 0.77 (0.15),respectively, for fatal traffic incidents. The crude overall mortality in the study population was 1193,with a mean ICISS 0.72 (0.17). Fatalities at university hospitals had the lowest mean ICISS 0.68(0.19). Regional and county hospitals had mean ICISS 0.75 (0.15) and 0.77 (0.15), respectively, forfatal traffic incidents. When regional and county hospitals were merged into one group and itsrisk-adjusted mortality compared with university hospitals, no significant difference was found. Acomparison between hospital groups with the most severely injured patients (ICISS ≤0.85) also didnot show a significant difference (odds ratio, 1.13; 95% confidence interval, 0.97–1.32).

Conclusions: This study shows that, in Sweden, the type of hospital does not influence risk adjustedtraffic related mortality, where the most severely injured patients are transported to the universityhospitals and centralization of treatment is common. 

Place, publisher, year, edition, pages
Oxford University Press, 2021. Vol. 9, article id tkaa051
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Surgery
Identifiers
URN: urn:nbn:se:liu:diva-174060DOI: 10.1093/burnst/tkaa051ISI: 000635609400001OAI: oai:DiVA.org:liu-174060DiVA, id: diva2:1536742
Note

Funding: Carnegie Foundation; Region Ostergotland; Linkoping University

Available from: 2021-03-12 Created: 2021-03-12 Last updated: 2022-05-26Bibliographically approved

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Ydenius, ViktorLarsen, RobertSteinvall, IngridChew, Michelle SSjöberg, Folke

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Division of Surgery, Orthopedics and OncologyFaculty of Medicine and Health SciencesDepartment of Anaesthesiology and Intensive Care in NorrköpingANOPIVA USDepartment of Hand and Plastic SurgeryDivision of Clinical Chemistry and Pharmacology
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