BACKGROUND: This article analyzes the effectiveness of designated trauma centers (DTCs) in Florida concerning reduction in the mortality risk of severely injured elderly trauma victims. METHODS: Inpatient hospital data collected by the Agency for Health Care Administration were used to identify elderly trauma patients. An instrumental variables method was used to adjust for prehospital selection bias in addition to the influence of age, gender, race, risk of mortality, comorbidities, and type of injury. The model was estimated using a bivariate probit full information maximum likelihood model to determine the impact of triage to a trauma center as opposed to a nontrauma hospital. RESULTS: After adjusting for confounding influences, treatment at a DTC was associated with a statistically significant reduction of 0.072, 0.040, and 0.036 in the probability of mortality for patients in the age groups 65 years to 74 years, 75 years to 84 years, and ≥ 85 years, respectively. CONCLUSIONS: Treatment of severely injured elderly trauma patients in DTCs is associated with statistically significant gains in the probability of survival.
BACKGROUND: This article analyzes the effectiveness of designated trauma centers (DTCs) in Florida concerning reduction in the mortality risk of severely injured elderly trauma victims. METHODS: Inpatient hospital data collected by the Agency for Health Care Administration were used to identify elderly traumapatients. An instrumental variables method was used to adjust for prehospital selection bias in addition to the influence of age, gender, race, risk of mortality, comorbidities, and type of injury. The model was estimated using a bivariate probit full information maximum likelihood model to determine the impact of triage to a trauma center as opposed to a nontrauma hospital. RESULTS: After adjusting for confounding influences, treatment at a DTC was associated with a statistically significant reduction of 0.072, 0.040, and 0.036 in the probability of mortality for patients in the age groups 65 years to 74 years, 75 years to 84 years, and ≥ 85 years, respectively. CONCLUSIONS: Treatment of severely injured elderly traumapatients in DTCs is associated with statistically significant gains in the probability of survival.
Authors: Craig D Newgard; James F Holmes; Jason S Haukoos; Eileen M Bulger; Kristan Staudenmayer; Lynn Wittwer; Eric Stecker; Mengtao Dai; Renee Y Hsia Journal: Injury Date: 2015-09-30 Impact factor: 2.586
Authors: Craig D Newgard; Zhuo Yang; Daniel Nishijima; K John McConnell; Stacy A Trent; James F Holmes; Mohamud Daya; N Clay Mann; Renee Y Hsia; Tom D Rea; N Ewen Wang; Kristan Staudenmayer; M Kit Delgado Journal: J Am Coll Surg Date: 2016-03-03 Impact factor: 6.113
Authors: Tabitha Garwe; Kenneth E Stewart; Craig D Newgard; Julie A Stoner; John C Sacra; Patrick Cody; Babawale Oluborode; Roxie M Albrecht Journal: Prehosp Emerg Care Date: 2019-07-16 Impact factor: 3.077
Authors: Tarsicio Uribe-Leitz; Molly P Jarman; Daniel J Sturgeon; Alyssa F Harlow; Stuart R Lipsitz; Zara Cooper; Ali Salim; Craig D Newgard; Adil H Haider Journal: Ann Emerg Med Date: 2019-11-13 Impact factor: 6.762