Impact of US hospital center and interhospital transfer on spinal cord injury management: An analysis of the National Trauma Data Bank.
| dc.contributor.author | Williamson, Theresa | |
| dc.contributor.author | Hodges, Sarah | |
| dc.contributor.author | Yang, Lexie Zidanyue | |
| dc.contributor.author | Lee, Hui-Jie | |
| dc.contributor.author | Gabr, Mostafa | |
| dc.contributor.author | Ugiliweneza, Beatrice | |
| dc.contributor.author | Boakye, Maxwell | |
| dc.contributor.author | Shaffrey, Christopher I | |
| dc.contributor.author | Goodwin, C Rory | |
| dc.contributor.author | Karikari, Isaac O | |
| dc.contributor.author | Lad, Shivanand | |
| dc.contributor.author | Abd-El-Barr, Muhammad | |
| dc.date.accessioned | 2023-06-19T18:23:23Z | |
| dc.date.available | 2023-06-19T18:23:23Z | |
| dc.date.issued | 2021-06 | |
| dc.date.updated | 2023-06-19T18:23:23Z | |
| dc.description.abstract | BackgroundTraumatic spinal cord injury (SCI) is a serious public health problem. Outcomes are determined by severity of immediate injury, mitigation of secondary downstream effects, and rehabilitation. This study aimed to understand how the center type a patient presents to and whether they are transferred influence management and outcome.MethodsThe National Trauma Data Bank was used to identify patients with SCI. The primary objective was to determine association between center type, transfer, and surgical intervention. A secondary objective was to determine association between center type, transfer, and surgical timing. Multivariable logistic regression models were fit on surgical intervention and timing of the surgery as binary variables, adjusting for relevant clinical and demographic variables.ResultsThere were 11,744 incidents of SCI identified. A total of 2,883 patients were transferred to a Level I center and 4,766 presented directly to a level I center. Level I center refers to level I trauma center. Those who were admitted directly to level I centers had a higher odd of receiving a surgery (odds ratio, 1.703; 95% confidence interval, 1.47-1.97; p < 0.001), but there was no significant difference in terms of timing of surgery. Patients transferred into a level I center were also more likely to undergo surgery than those at a level II/III/IV center, although this was not significant (odds ratio, 1.213; 95% confidence interval, 0.099-1.48; p = 0.059).ConclusionPatients with traumatic SCI admitted to level I trauma centers were more likely to have surgery, particularly if they were directly admitted to a level I center. This study provides insights into a large US sample and sheds light on opportunities for improving pre hospital care pathways for patients with traumatic SCI, to provide the timely and appropriate care and achieve the best possible outcomes.Level of evidenceCare management, Level IV. | |
| dc.identifier | 01586154-202106000-00021 | |
| dc.identifier.issn | 2163-0755 | |
| dc.identifier.issn | 2163-0763 | |
| dc.identifier.uri | ||
| dc.language | eng | |
| dc.publisher | Ovid Technologies (Wolters Kluwer Health) | |
| dc.relation.ispartof | The journal of trauma and acute care surgery | |
| dc.relation.isversionof | 10.1097/ta.0000000000003165 | |
| dc.subject | Humans | |
| dc.subject | Spinal Cord Injuries | |
| dc.subject | Treatment Outcome | |
| dc.subject | Patient Admission | |
| dc.subject | Patient Transfer | |
| dc.subject | Neurosurgical Procedures | |
| dc.subject | Retrospective Studies | |
| dc.subject | Databases, Factual | |
| dc.subject | Adult | |
| dc.subject | Aged | |
| dc.subject | Middle Aged | |
| dc.subject | Trauma Centers | |
| dc.subject | United States | |
| dc.subject | Female | |
| dc.subject | Male | |
| dc.subject | Time-to-Treatment | |
| dc.subject | Conservative Treatment | |
| dc.title | Impact of US hospital center and interhospital transfer on spinal cord injury management: An analysis of the National Trauma Data Bank. | |
| dc.type | Journal article | |
| duke.contributor.orcid | Yang, Lexie Zidanyue|0000-0002-4843-4313 | |
| duke.contributor.orcid | Gabr, Mostafa|0000-0003-2058-2098 | |
| duke.contributor.orcid | Shaffrey, Christopher I|0000-0001-9760-8386 | |
| duke.contributor.orcid | Goodwin, C Rory|0000-0002-6540-2751 | |
| duke.contributor.orcid | Lad, Shivanand|0000-0003-4991-5319 | |
| duke.contributor.orcid | Abd-El-Barr, Muhammad|0000-0001-7151-2861 | |
| pubs.begin-page | 1067 | |
| pubs.end-page | 1076 | |
| pubs.issue | 6 | |
| pubs.organisational-group | Duke | |
| pubs.organisational-group | School of Medicine | |
| pubs.organisational-group | Faculty | |
| pubs.organisational-group | Staff | |
| pubs.organisational-group | Basic Science Departments | |
| pubs.organisational-group | Clinical Science Departments | |
| pubs.organisational-group | Institutes and Centers | |
| pubs.organisational-group | Biostatistics & Bioinformatics | |
| pubs.organisational-group | Orthopaedic Surgery | |
| pubs.organisational-group | Psychiatry & Behavioral Sciences | |
| pubs.organisational-group | Radiation Oncology | |
| pubs.organisational-group | Duke Cancer Institute | |
| pubs.organisational-group | Institutes and Provost's Academic Units | |
| pubs.organisational-group | University Institutes and Centers | |
| pubs.organisational-group | Duke Institute for Brain Sciences | |
| pubs.organisational-group | Initiatives | |
| pubs.organisational-group | Neurosurgery | |
| pubs.organisational-group | Duke Innovation & Entrepreneurship | |
| pubs.organisational-group | Duke - Margolis Center For Health Policy | |
| pubs.publication-status | Published | |
| pubs.volume | 90 |
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