| Geographic cluster analysis of injury severity and hospital resource use in a regional trauma system. | |
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MedLine Citation:
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PMID: 20095830 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To determine clusters of trauma incidents with high injury severity and resource utilization and to test their association with census demographic information. METHODS: Using "trauma band" unique identifiers and probabilistic linkage for unmatched cases, we matched injury location information collected from a centralized regional trauma communications center to the state trauma system registry for patients directly transported to two level I trauma centers for the years 2001-2003 in a three-county area. The injury locations were aggregated at the census tract level using a geographic information system (GIS). Moran's I analysis was used to determine clusters of census tracts that had a high incidence of either total trauma injuries, Injury Severity Scores (ISSs) >15, or high resource use (in-hospital mortality, admission to the intensive care unit, or major nonorthopedic surgery). These clusters were then tested for association with census tract demographics using logistic regression. RESULTS: Eight thousand seven hundred fifty-one injured persons were directly transported from the tricounty area to a trauma center during the study period. The mean (+/- standard deviation) age was 37 +/- 21 years, 67.4% were male, 18.9% had ISSs >15, and 29.8% had a high-resource-use indicator. Moran's I analysis demonstrated a single large cluster of incidents for total injuries, ISS >15, and occurrence of a high-resource-use indictor that overlapped except for one small census tract. Logistic regression revealed that the high-risk cluster was associated with a higher prevalence of nonwhite population and vacant housing and a lower prevalence of foreign-born residents and family housing. CONCLUSIONS: GIS cluster analysis demonstrated high-risk census tracts for trauma incidents and associated population demographics. Geospatial analyses may assist injury prevention interventions and emergency medical services deployment strategies for trauma. |
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Authors:
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Craig Warden; Ritu Sahni; Craig Newgard |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors Volume: 14 ISSN: 1545-0066 ISO Abbreviation: Prehosp Emerg Care Publication Date: 2010 Apr-Jun |
Date Detail:
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Created Date: 2010-03-04 Completed Date: 2010-06-02 Revised Date: 2012-04-04 |
Medline Journal Info:
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Nlm Unique ID: 9703530 Medline TA: Prehosp Emerg Care Country: England |
Other Details:
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Languages: eng Pagination: 137-44 Citation Subset: IM |
Affiliation:
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Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon 97239, USA. warden@ohsu.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Algorithms Cluster Analysis Female Geographic Information Systems* Hospitals / utilization* Humans Male Middle Aged Observation Retrospective Studies Trauma Severity Indices* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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