Yeen Wing, Carrillo Eddy H, Bragg Sally, Marsh Wallace, Gilson Seth, Meltzer Tracy
Division of Cardio-Thoracic Surgery, Ohio State University, Columbus, OH, USA.
Division of Trauma Services, Memorial Regional Hospital, Hollywood, FL, 33027, USA.
Eur J Trauma Emerg Surg. 2007 Jun;33(3):251-5. doi: 10.1007/s00068-007-6057-1. Epub 2007 May 11.
Vertical deceleration injury is a known but not well understood form of blunt injury in both the urban and rural environment. The purpose of this study was to investigate the financial cost of treatment for this specific mechanism of injury in the acute care setting, and to continue to expand a fall prevention program from our unit.
This is a prospective review of vertical deceleration injuries admitted over a 2-year period to a Level I trauma center. Patients were followed until discharge to either home or rehabilitation facilities.
Ninety-nine patients who sustained a vertical deceleration injury from a height of ≥ 6 ft were identified from our Trauma Registry database. The length of hospital stay, including rehabilitation, ranged from 1 to 78 days (mean, 13.1 days). The mean injury severity score (ISS) was 16.4 (range, 4-75). The average height of fall was 19.5 ft (range, 6-110 ft) with a mean impact velocity of 23 mph (range, 13-58). The cost of hospitalization was significantly correlated to the ISS score (correlation = 0.558, p < 0.001); and as expected, higher ISS scores yielded higher costs (χ(2) = 34.7, p < 0.001). We found that the best predictor variable for the cost of treatment for vertical deceleration injury is the ISS score with a regression equation of: Cost = $19,578 + ($6,609 × ISS). The average cost per fall incident was $91,435 (range $5,006-$948,957) for vertical deceleration injuries.
The cost of treatment of vertical deceleration injuries is very high. Hospital stays are prolonged and rehabilitation needs frequent. Overall, ISS is the best predictor of cost of treatment and length of hospital stay.
垂直减速伤是一种在城市和农村环境中都已知但尚未完全理解的钝性损伤形式。本研究的目的是调查急性护理环境中这种特定损伤机制的治疗费用，并继续扩大我们科室的预防跌倒计划。
这是一项对一家一级创伤中心在两年期间收治的垂直减速伤患者的前瞻性回顾研究。对患者进行随访直至出院回家或康复机构。
从我们的创伤登记数据库中识别出99例从≥6英尺高度遭受垂直减速伤的患者。住院时间（包括康复期）为1至78天（平均13.1天）。平均损伤严重程度评分（ISS）为16.4（范围4 - 75）。平均坠落高度为19.5英尺（范围6 - 110英尺），平均撞击速度为23英里/小时（范围13 - 58）。住院费用与ISS评分显著相关（相关性 = 0.558，p < 0.001）；正如预期的那样，ISS评分越高，费用越高（χ(2) = 34.7，p < 0.001）。我们发现，垂直减速伤治疗费用的最佳预测变量是ISS评分，回归方程为：费用 = 19,578美元 +（6,609美元×ISS）。垂直减速伤每次跌倒事件的平均费用为91,435美元（范围5,006美元 - 948,957美元）。
垂直减速伤的治疗费用非常高。住院时间延长且康复需求频繁。总体而言，ISS是治疗费用和住院时间的最佳预测指标。
