Duncan Anthony J, Velez David R, Zreik Khaled
Department of Surgery, University of North Dakota School of Medicine and Health Sciences, Grand Forks, USA.
Department of Surgical Critical Care, Sanford Medical Center, Fargo, USA.
Cureus. 2025 May 20;17(5):e84479. doi: 10.7759/cureus.84479. eCollection 2025 May.
Workloads of healthcare professionals have continued to increase in recent years. With increased workload, some studies have shown increased length of stay for patients, higher cost, and higher risk of patient safety events. Trauma teams are a group that is particularly vulnerable to changes in patient census. This study aims to evaluate the impact of high versus low trauma team census on outcomes.
A retrospective review of all rib fracture patients at a level I trauma center from 2017 to 2022 was conducted. The average daily census was determined, and high or low census days were assessed by being above or below this, respectively. The impact of census levels on outcomes was assessed using bivariate analysis and multivariate regression.
A total of 1,291 patients were included, with 663 admitted on high census days and 628 admitted on low census days. Demographics and comorbidities were similar between groups. Surgical fixation rates and time to surgery were similar between census levels. High census admissions had lower ICU admission rates (odds ratio (OR): 0.78, p=0.034) and higher delirium risk (OR: 3.21, p=0.005).
Despite some seasonal variation between groups, patients admitted on high and low census days have similar demographics and prehospital comorbidities. However, patients admitted on high census days were less likely to receive ICU admission and had increased delirium rates, raising concerns about under-triage and emphasizing the need for improved resource allocation during high-volume periods.
近年来，医疗保健专业人员的工作量持续增加。随着工作量的增加，一些研究表明患者住院时间延长、成本增加以及患者安全事件风险升高。创伤团队是特别容易受到患者普查变化影响的群体。本研究旨在评估高创伤团队普查与低创伤团队普查对结果的影响。
对一家一级创伤中心2017年至2022年期间所有肋骨骨折患者进行回顾性研究。确定每日平均普查人数，并分别以上述人数为界评估高普查日或低普查日。使用双变量分析和多变量回归评估普查水平对结果的影响。
共纳入1291例患者，其中663例在高普查日入院，628例在低普查日入院。两组间的人口统计学和合并症相似。普查水平之间的手术固定率和手术时间相似。高普查日入院患者的ICU入院率较低（优势比（OR）：0.78，p = 0.034），谵妄风险较高（OR：3.21，p = 0.005）。
尽管两组之间存在一些季节性差异，但高普查日和低普查日入院的患者在人口统计学和院前合并症方面相似。然而，高普查日入院的患者接受ICU入院的可能性较小，谵妄发生率增加，这引发了对分诊不足的担忧，并强调在高容量时期需要改善资源分配。
