Mitchell Rebecca J, Curtis Kate, Braithwaite Jeffrey
Australian Institute of Health Innovation, Macquarie University, Australia.
Sydney Nursing School, The University of Sydney, Australia; St George Hospital, Sydney, Australia.
Injury. 2017 Aug;48(8):1776-1783. doi: 10.1016/j.injury.2017.06.002. Epub 2017 Jun 8.
The prevalence of chronic health conditions such as diabetes among young people is increasing. Limited information is known about the impact of these conditions on young people who have been traumatically injured. Injury is the global leading cause of death and disability in young people. The aim of this study is to compare health outcomes for injured young people with and without chronic health conditions.
A retrospective examination of injury in young people aged≤25years with and without a chronic health condition using linked hospitalisation and mortality records during 1 January 2010 to 30 June 2014 in New South Wales, Australia. Health outcomes, including hospital length of stay (LOS), 28-day unplanned hospital readmission, hospital treatment costs, and 30-day and 12-month mortality were examined. A 1:1 matched design was used to determine excess mean hospital LOS and cost for young people with a chronic health conditions versus no health condition.
There were 184,819 injury-related hospitalisations of young people; 13.8% had a chronic health condition. Compared to young people who did not have a chronic health condition, those with one were found to have double the mean hospital cost, higher unplanned hospital readmission, and a higher rate of mortality. Injured young people had a three times higher likelihood of having a prolonged LOS if they had a chronic health condition (Adjusted odds ratio: 3.89; 95% CI: 3.69-4.11). Renal conditions, anaemia, coagulation defects, hypertension, and mental health conditions had the highest excess LOS and anaemia, hypertension, coagulation defects and renal conditions had the highest excess mean cost for matched injured individuals with and without the health condition.
Health outcomes following injury are worse for young people with a chronic health condition. The increasing prevalence of young people with a chronic health condition has implications for treatment, resource use, provision of support services, and survival following traumatic injury.
糖尿病等慢性健康状况在年轻人中的患病率正在上升。关于这些疾病对遭受创伤性损伤的年轻人的影响，我们所知有限。损伤是全球年轻人死亡和残疾的主要原因。本研究的目的是比较有和没有慢性健康状况的受伤年轻人的健康结局。
利用澳大利亚新南威尔士州2010年1月1日至2014年6月30日期间的住院和死亡记录，对年龄≤25岁、有和没有慢性健康状况的年轻人的损伤情况进行回顾性研究。检查了包括住院时间（LOS）、28天非计划再次入院、住院治疗费用以及30天和12个月死亡率等健康结局。采用1:1匹配设计来确定患有慢性健康状况的年轻人与没有健康状况的年轻人相比，平均住院时间和费用的超额情况。
有184,819例与损伤相关的年轻人住院病例；13.8%患有慢性健康状况。与没有慢性健康状况的年轻人相比，患有慢性健康状况的年轻人平均住院费用高出一倍，非计划再次入院率更高，死亡率也更高。如果受伤的年轻人患有慢性健康状况，其住院时间延长的可能性高出三倍（调整后的优势比：3.89；95%置信区间：3.69 - 4.11）。肾脏疾病、贫血、凝血缺陷、高血压和心理健康状况导致的住院时间超额最高，贫血、高血压、凝血缺陷和肾脏疾病导致的匹配受伤个体（有和没有健康状况）的平均费用超额最高。
患有慢性健康状况的年轻人受伤后的健康结局更差。患有慢性健康状况的年轻人患病率上升对创伤性损伤后的治疗、资源利用、支持服务的提供以及生存都有影响。
