Institute of Disaster and Emergency Medicine, Tianjin University, Tianjin, China.
Department of Orthopaedic Surgery, Tianjin Hospital, Tianjin University, Tianjin, China.
Eur J Trauma Emerg Surg. 2024 Apr;50(2):425-437. doi: 10.1007/s00068-023-02353-2. Epub 2023 Aug 31.
This investigation aimed to understand the epidemiological characteristics and hospitalization burden and its possible influencing factors of patients with different injury mechanisms.
All trauma patients admitted via the emergency department at a trauma center from November 1, 2020, to April 30, 2022, were identified. The hospitalization burden, including the number of hospitalizations, deaths and in-hospital mortality, length of stay (LOS), and medical costs, was calculated. Univariate and multivariate logistic regression models were used to analyze the factors influencing the hospitalization burden of trauma. The receiver-operating characteristic (ROC) curves were drawn to evaluate the predictive value of the multivariate model.
16 485 trauma patients with 16 552 hospitalizations were included, with an in-hospital mortality rate of 1.269‰, median LOS of 7 days, and median hospitalization costs of 54 725.28 CNY. The median age was 52 years. 62.54% were hospitalized due to falls. The upper and lower extremities were the most common injury regions. There are differences between the demographic, injury, and hospitalization characteristics and factors influencing hospitalization burden across injury mechanisms, but there were also common influencing factors. Injury region, surgery, transfusion, and ICU treatment are influential factors for prolonged LOS. Age, injury region, surgery, and transfusion were influential factors for high hospitalization costs.
This study provided primary evidence on the hospitalization burden of trauma. Considering demographics, injury and hospitalization characteristics as additional discriminators could further intervene in LOS and medical costs. Targeted efforts to use more early prevention measures could potentially lower future hospitalization burden.
本研究旨在了解不同损伤机制患者的流行病学特征和住院负担及其可能的影响因素。
本研究纳入了 2020 年 11 月 1 日至 2022 年 4 月 30 日期间通过创伤中心急诊科收治的所有创伤患者。计算了住院负担，包括住院次数、死亡和院内死亡率、住院时间（LOS）和医疗费用。采用单因素和多因素逻辑回归模型分析影响创伤住院负担的因素。绘制受试者工作特征（ROC）曲线评估多因素模型的预测价值。
共纳入 16485 例创伤患者，共 16552 例次住院，院内死亡率为 1.269‰，中位 LOS 为 7 天，中位住院费用为 54725.28 元。患者中位年龄为 52 岁，62.54%因跌倒住院。上肢和下肢是最常见的受伤部位。不同损伤机制的患者在人口统计学、损伤和住院特征以及影响住院负担的因素方面存在差异，但也存在共同的影响因素。损伤部位、手术、输血和 ICU 治疗是 LOS 延长的影响因素。年龄、损伤部位、手术和输血是住院费用高的影响因素。
本研究为创伤住院负担提供了初步证据。考虑人口统计学、损伤和住院特征作为附加判别因素，可能进一步干预 LOS 和医疗费用。有针对性地使用更多早期预防措施可能会降低未来的住院负担。
