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Decreased risk adjusted 30-day mortality for hospital admitted injuries: a multi-centre longitudinal study
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Linköping. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Hand and Plastic Surgery.
Linköping University, Department of Clinical and Experimental Medicine, Division of Surgery, Orthopedics and Oncology. Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Anaesthesiology and Intensive Care in Norrköping.ORCID iD: 0000-0003-4075-4600
Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, 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.
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2018 (English)In: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, ISSN 1757-7241, E-ISSN 1757-7241, Vol. 26, no 1, article id 24Article in journal (Refereed) Published
Abstract [en]

Background: The interpretation of changes in injury-related mortality over time requires an understanding of changes in the incidence of the various types of injury, and adjustment for their severity. Our aim was to investigate changes over time in incidence of hospital admission for injuries caused by falls, traffic incidents, or assaults, and to assess the risk-adjusted short-term mortality for these patients.less thanbr /greater thanMethods: All patients admitted to hospital with injuries caused by falls, traffic incidents, or assaults during the years 2001-11 in Sweden were identified from the nationwide population-based Patient Registry. The trend in mortality over time for each cause of injury was adjusted for age, sex, comorbidity and severity of injury as classified from the International Classification of diseases, version 10 Injury Severity Score (ICISS).less thanbr /greater thanResults: Both the incidence of fall (689 to 636/100000 inhabitants: p = 0.047, coefficient - 4.71) and traffic related injuries (169 to 123/100000 inhabitants: p less than 0.0001, coefficient - 5.37) decreased over time while incidence of assault related injuries remained essentially unchanged during the study period. There was an overall decrease in risk-adjusted 30-day mortality in all three groups (OR 1.00; CI95% 0.99-1.00). Decreases in traffic (OR 0.95; 95% CI 0.93 to 0.97) and assault (OR 0.93; 95% CI 0.87 to 0.99) related injuries was significant whereas falls were not during this 11-year period.less thanbr /greater thanDiscussion: Risk-adjustment is a good way to use big materials to find epidemiological changes. However after adjusting for age, year, sex and risk we find that a possible factor is left in the pre- and/or in-hospital care.less thanbr /greater thanConclusions: The decrease in risk-adjusted mortality may suggest changes over time in pre- and/or in-hospital care. A non-significantdecrease in risk-adjusted mortality was registered for falls, which may indicate that low-energy trauma has not benefited for the increased survivability as much as high-energy trauma, ie traffic- and assault related injuries.

Place, publisher, year, edition, pages
2018. Vol. 26, no 1, article id 24
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Surgery
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URN: urn:nbn:se:liu:diva-146965DOI: 10.1186/s13049-018-0485-2ISI: 000429285700002PubMedID: 29615089OAI: oai:DiVA.org:liu-146965DiVA, id: diva2:1196040
Available from: 2018-04-09 Created: 2018-04-09 Last updated: 2018-04-26

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Larsen, RobertBäckström, DeniseFredrikson, MatsSteinvall, Ingrid

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Larsen, RobertBäckström, DeniseFredrikson, MatsSteinvall, IngridSjöberg, Folke
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Division of Surgery, Orthopedics and OncologyDepartment of Medical and Health SciencesFaculty of Medicine and Health SciencesDepartment of Anaesthesiology and Intensive Care in LinköpingDepartment of Hand and Plastic SurgeryDepartment of Anaesthesiology and Intensive Care in NorrköpingDivision of Neuro and Inflammation Science
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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
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