Department of Surgery, Division of Trauma and Acute Care Surgery, Penn Medicine Lancaster General Health, Lancaster, PA, USA.
Business Intelligence, Penn Medicine Lancaster General Health, Lancaster, PA, USA.
Am Surg. 2023 Aug;89(8):3597-3599. doi: 10.1177/00031348231160845. Epub 2023 Mar 16.
Social determinants (SD) refer to a variety of environmental factors that can influence certain clinical outcomes. SD that affect clinical outcomes in trauma patients are largely understudied. We hypothesized that patients with an "at risk" (AR) classification for any SD will have a greater frequency of negative outcomes when compared to their "not at risk" (NAR) counterparts. A retrospective review was performed (1/2021-2/2022) of all trauma patients that met the inclusion criteria. 2225 patients were included. SD included (based on collection rates) for analysis were: tobacco use, stress, and intimate partner violence. Tobacco usage was the only SD that was significantly associated with a higher 30-day mortality. This study demonstrated a paucity of data in the medical record regarding SD. In an effort to provide more inclusive care and address health disparities in our patient population, there is a need for more complete data collection upon admission/duration of hospital stay.
社会决定因素（SD）是指各种环境因素，这些因素可能会影响某些临床结果。影响创伤患者临床结果的 SD 因素在很大程度上研究不足。我们假设，与“无风险”（NAR）患者相比，任何 SD 具有“风险”（AR）分类的患者出现负面结果的频率更高。对符合纳入标准的所有创伤患者进行了回顾性研究（2021 年 1 月至 2022 年 2 月）。共纳入 2225 例患者。纳入分析的 SD 包括（基于收集率）：烟草使用、压力和亲密伴侣暴力。烟草使用是唯一与 30 天死亡率升高显著相关的 SD。本研究表明，医疗记录中关于 SD 的数据很少。为了在我们的患者群体中提供更具包容性的护理和解决健康差距，在入院时/住院期间需要更完整的数据收集。
