跌倒所致创伤入院的结局：种族和年龄对住院期间及出院后死亡率的影响。
Outcomes of trauma admission for falls: influence of race and age on inhospital and post-discharge mortality.
作者信息
Strong Bethany L, Torain Jamila M, Greene Christina R, Smith Gordon S
机构信息
Department of Epidemiology and Public Health, University of Maryland School of Medicine, 601 West Lombard Street, Baltimore, MD 21201, USA.
Department of Epidemiology and Public Health, University of Maryland School of Medicine, 601 West Lombard Street, Baltimore, MD 21201, USA.
出版信息
Am J Surg. 2016 Oct;212(4):638-644. doi: 10.1016/j.amjsurg.2016.06.002. Epub 2016 Jul 18.
BACKGROUND
Racial disparities in trauma outcomes occur, but disparities in fall mortality are unknown. The objective of this study was to determine inhospital and 1-year fall mortality among patients discharged from an urban trauma center.
METHODS
We conducted a retrospective analysis of fall patients in our trauma registry (1997 to 2008) linked to the National Death Index to determine postdischarge mortality. Statistical analysis included chi-square tests, multivariable logistic regression, and Cox proportional hazards models.
RESULTS
There were 7,541 fall admissions. There was no clinically significant difference in inhospital mortality between blacks and whites with age stratification. One year after discharge, blacks younger than 65 years were more likely to die of disease (hazard ratio, 1.37; 95% confidence interval, 1.14 to 1.62).
CONCLUSIONS
Although rates of inhospital mortality are similar, blacks younger than 65 years have a higher risk of dying after discharge due to disease when stratified by age highlighting the need for continued medical follow-up and prevention efforts.
背景
创伤结局存在种族差异，但跌倒死亡率的差异尚不清楚。本研究的目的是确定从城市创伤中心出院的患者的住院期间及1年跌倒死亡率。
方法
我们对创伤登记处（1997年至2008年）的跌倒患者进行了回顾性分析，并与国家死亡指数相联系以确定出院后死亡率。统计分析包括卡方检验、多变量逻辑回归和Cox比例风险模型。
结果
共有7541例跌倒入院患者。按年龄分层后，黑人和白人的住院死亡率无临床显著差异。出院1年后，65岁以下的黑人死于疾病的可能性更高（风险比，1.37；95%置信区间，1.14至1.62）。
结论
尽管住院死亡率相似，但按年龄分层时，65岁以下的黑人出院后因疾病死亡的风险更高，这突出表明需要持续的医学随访和预防措施。
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