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Research Studies is a monthly compilation of research articles funded by AHRQ or authored by AHRQ researchers and recently published in journals or newsletters.
Results1 to 25 of 88 Research Studies Displayed
Danan ER, Brunner J, Bergman A
The relationship between sexual assault history and cervical cancer screening completion among women veterans in the Veterans Health Administration.
The purpose of this study was to determine whether a history of sexual assault in women Veterans is associated with decreased cervical cancer screening completion. The researchers analyzed data from a 2015 survey of 1049 women Veterans who accessed primary care services at 12 Veterans health administration facilities (VA’s) in nine states, and linked responses with electronic health data from the VA system. Fifty-seven percent (616) of women Veterans reported lifetime sexual assault, and those who did so had a greater likelihood of reporting a high level of distress associated with pelvic examinations and delaying a gynecologic exam due to distress. However, in the final adjusted model, there was not a significant association between lifetime sexual assault and reduced odds of cervical cancer screening completion. The study concluded that there was no significant association between sexual assault and gaps in cervical cancer screening completion.
Citation: Danan ER, Brunner J, Bergman A . The relationship between sexual assault history and cervical cancer screening completion among women veterans in the Veterans Health Administration. J Womens Health 2022 Jul;31(7):1040-47. doi: 10.1089/jwh.2021.0237.AHRQ-funded; HS026379..
Keywords: Women, Veterans, Cancer: Cervical Cancer, Cancer, Screening, Trauma
Maughan BC, Lin A, Caughey AB
Field trauma triage among older adults: a cost-effectiveness analysis.
The authors evaluated the cost-effectiveness of a high-sensitivity triage strategy for older adults. They used a microsimulation model with a retrospective cohort of community-dwelling Medicare beneficiaries transported by emergency medical services after an acute injury. They found that high-sensitivity trauma field triage is not cost-effective among older adults.
Citation: Maughan BC, Lin A, Caughey AB . Field trauma triage among older adults: a cost-effectiveness analysis. J Am Coll Surg 2022 Feb 1;234(2):139-54. doi: 10.1097/xcs.0000000000000025..
Keywords: Elderly, Trauma, Healthcare Costs, Value
Hoonakker PLT, Hose BZ, Carayon P
Scenario-based evaluation of team health information technology to support pediatric trauma care transitions.
This study’s objective was to examine if the Teamwork Transition Technology (T(3)) supports teams and team cognition. Using a scenario-based mock-up methodology with 36 clinicians and staff from the different units and departments who are involved in pediatric trauma to examine T(3), results showed that most participants agreed that the technology helped to achieve the goals set out in the design phase. Respondents thought that T(3) organized and presented information in a different way that was helpful to them. The authors concluded that the results of their evaluation showed that participants agreed that T(3) does support them in their work and increases their situation awareness.
Citation: Hoonakker PLT, Hose BZ, Carayon P . Scenario-based evaluation of team health information technology to support pediatric trauma care transitions. Appl Clin Inform 2022 Jan;13(1):218-29. doi: 10.1055/s-0042-1742368.
Keywords: Children/Adolescents, Transitions of Care, Health Information Technology (HIT), Teams, Trauma
Johnson BN, McKernan L
Co-occurring trauma and non-suicidal self-injury among people with chronic pain: a systematic review.
The authors conducted a systematic review on the intersection of trauma, chronic pain, and non-suicidal self-injury (NSSI). They found that self-harm rates varied across studies, though appeared elevated among patients with chronic pain, and childhood trauma was linked to this co-occurrence. Further, causal links between trauma, NSSI, and pain were proposed, highlighting the need for a comprehensive theoretical model. They recommended assessing for childhood trauma when treating patients with chronic pain and querying regarding NSSI when patients present with indicators of NSSI risk and to treat or refer such patients to specialized treatment.
Citation: Johnson BN, McKernan L . Co-occurring trauma and non-suicidal self-injury among people with chronic pain: a systematic review. Curr Pain Headache Rep 2021 Nov 11;25(11):70. doi: 10.1007/s11916-021-00984-x..
Keywords: Trauma, Behavioral Health, Chronic Conditions
Holler E, Meagher AD, Ortiz D
Preinjury functional independence is not associated with discharge location in older trauma patients.
This study’s purpose was to evaluate the association between pre-injury Katz Index of Independence in Activities of Daily Living (Katz ADL) functional status and discharge to a facility in non-neurologically injured trauma patients. Data from 207 subjects in the Trauma Medical Home study cohort was obtained. Patients were predominantly white (89.4%) and female (52.2%). The most common trauma injury was a fall (48.3%), followed by automobile crash (41.1%). There was no relationship between pre-injury independence and the likelihood of discharge home. Over half of patients (51.7%) were discharged home, 37.7% to subacute rehabilitation., 10.1% to acute rehabilitation, and 0.5% to long-term acute care. Patients who self-reported depression and anxiety who weren’t sent home was associated with age, being single, and being female.
Citation: Holler E, Meagher AD, Ortiz D . Preinjury functional independence is not associated with discharge location in older trauma patients. J Surg Res 2021 Oct;266:413-20. doi: 10.1016/j.jss.2021.04.029..
Keywords: Elderly, Trauma, Hospital Discharge
Bongiovanni T, Hernandez S, Ledesma Y
Surviving traumatic injury, only to die of acute drug poisoning: should trauma centers be a path for intervention?
This study’s objective was to determine the incidence and characteristics of and risk factors for trauma patients suffering death by unintentional drug overdose. This retrospective chart review was conducted on all admitted trauma patients 18 years or older at the only level-1 trauma center in the San Francisco area from 2012 to 2012, matched with unintentional overdose decedents from the California death registry. Of 9,860 patients residing in San Francisco at the time of their trauma during the study period 1,418 died, 107 (0.3/100 person-years) from unintentional overdose. Overdose decedents were 84% male, 50% white, with a mean age of 48 years. Twenty percent of deaths occurred within 3 months of hospitalization, and 40% were attributed to a prescription opioid.
AHRQ-funded; HS026383; 233201500020I.
Citation: Bongiovanni T, Hernandez S, Ledesma Y . Surviving traumatic injury, only to die of acute drug poisoning: should trauma centers be a path for intervention? Surgery 2021 Oct;170(4):1249-54. doi: 10.1016/j.surg.2021.03.003.
AHRQ-funded; HS026383; 233201500020I..
AHRQ-funded; HS026383; 233201500020I..
Keywords: Trauma, Medication, Risk, Mortality
Bradbury KR, Williams C, Leonard S
Emotional aspects of pediatric post-intensive care syndrome following traumatic brain injury.
This study assessed parent-reported emotional functioning in children with traumatic brain injury (TBI) and identified risk factors for emotional sequelae in the acute recovery phase. Results from logistic regression indicated that only elevated parent PTSD symptoms were a significant predictor for child anxiety and depressive symptoms. Anxiety and depressive symptoms were prevalent in the acute recovery phase of TBI. Consistent with previous research, elevations in anxiety and depressive symptoms were more related to psychosocial factors than to injury severity.
Citation: Bradbury KR, Williams C, Leonard S . Emotional aspects of pediatric post-intensive care syndrome following traumatic brain injury. J Child Adolesc Trauma 2021 Jun;14(2):177-87. doi: 10.1007/s40653-020-00332-y..
Keywords: Children/Adolescents, Brain Injury, Trauma, Neurological Disorders
Anderson MC, Evans E, Zonfrillo MR
Rural/urban differences in discharge from rehabilitation in older adults with traumatic brain injury.
This study compared differences in outcomes for older adults with traumatic brain injury (TBI) in rural and urban settings by 1) comparing the rates of successful community discharge; and 2) reasons for not achieving successful discharge. This retrospective national cohort study looked at skilled nursing facility (SNF) patients aged 66 and older using Medicare inpatient claims with Minimum Data Set assessments. A total of 11,771 SNFs were identified with a total population of 61,021 Medicare beneficiaries discharged to a SNF following hospitalization for TBI between 2011 and 2015. Patients in rural settings had lower rates of successful discharge compared with patients in urban settings (52.1% vs 58.5%). Reasons for unsuccessful discharge differed between rural and urban settings with rural patients less likely to discharged from SNF within 100 days although they were less likely to be rehospitalized within 30 days of SNF discharge.
Citation: Anderson MC, Evans E, Zonfrillo MR . Rural/urban differences in discharge from rehabilitation in older adults with traumatic brain injury. J Am Geriatr Soc 2021 Jun;69(6):1601-08. doi: 10.1111/jgs.17065..
Keywords: Elderly, Brain Injury, Trauma, Rural Health, Urban Health, Rehabilitation, Nursing Homes
Piantino JA, Lin A, Luther M
Simultaneous heart rate variability and electroencephalographic monitoring in children in the emergency department.
This study’s objective was to determine the clinical value of using changes in heart rate variability (HRV) and electroencephalographic (EEG) background in children with acute trauma seen in the Emergency Department (ED) as early predictors of outcome. A novel wireless monitoring device was piloted in 17 patients with 15 patients having EEG data rated as appropriate for clinical interpretation. This was compared to EEG and HRV data successfully collected in 167 subjects. Results showed recording early HRV and EEG is feasible in children with acute injury. This new tool may offer an early, non-invasive marker for injury stratification and prognosis in children.
Citation: Piantino JA, Lin A, Luther M . Simultaneous heart rate variability and electroencephalographic monitoring in children in the emergency department. J Child Adolesc Trauma 2021 Jun;14(2):165-75. doi: 10.1007/s40653-020-00313-1..
Keywords: Children/Adolescents, Emergency Department, Trauma, Outcomes
Rosenman ED, Misisco A, Olenick J
Does team leader gender matter? A Bayesian reconciliation of leadership and patient care during trauma resuscitations.
This study assessed and compared team leadership and patient care in trauma resuscitations led by male and female physicians. A secondary analysis of data from a larger randomized controlled trial using video recordings of resuscitations at a Level 1 trauma center from April 2016 to December 2017 was conducted. A total of 60 participants and 120 video observations were included in the analysis. There was a weak positive effect for female leaders for both patient care and team leadership. Gender-based advantages to team leadership and clinical care were not conclusive with the exception of rejecting a strong male advantage to team leadership.
Citation: Rosenman ED, Misisco A, Olenick J . Does team leader gender matter? A Bayesian reconciliation of leadership and patient care during trauma resuscitations. J Am Coll Emerg Physicians Open 2021 Feb;2(1):e12348. doi: 10.1002/emp2.12348..
Keywords: Teams, Trauma, Critical Care, Provider: Physician, Provider
Azadani EN, Townsend J, Peng J
The association between traumatic dental and brain injuries in American children.
This study examined the association between dento-alveolar trauma (DAT) and traumatic brain injuries (TBIs) among children ages 0-18 years. The Nationwide Emergency Department Sample (NEDS), an HCUP dataset, was analyzed using ICD-9-CM codes for the 2010-2014 NEDS data. Out of 6,281,658 emergency department (ED) visits, DAT was recorded in 93,408 (1.5%) visits and TBI was recorded in 996,334 (15.9%) visits. Of the DAT-positive encounters, 7.5% had codes associated with TBI. Patients with DAT had 0.20 odds of having TBI compared with patients who did not DAT when all confounding variables were kept constant. Multiple injuries, being involved in motor vehicle crashes, and injuries due to assault were associated with higher odds of concomitant TBI in patients who sustained DAT.
Citation: Azadani EN, Townsend J, Peng J . The association between traumatic dental and brain injuries in American children. Dent Traumatol 2021 Feb;37(1):114-22. doi: 10.1111/edt.12611..
Keywords: Healthcare Cost and Utilization Project (HCUP), Children/Adolescents, Emergency Department, Trauma, Neurological Disorders, Dental and Oral Health
Luther M, Poppert Cordts KM, Williams CN
Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery.
This is a systematic review to quantify sleep wake disturbances (SWD) after pediatric traumatic brain injury (TBI). These SWD can place children at risk for worse outcomes since sleep is needed for brain development and healing after injury. They also evaluated interventions for SWD and the association between SWD and other post-traumatic outcomes. Literature was searched from 1999-2019 evaluating sleep or fatigue in children hospitalized for TBI. Two independent reviewers assessed quality of the studies using the Newcastle-Ottowa Score for observational studies. Out of 966 identified articles, 126 full text articles were reviewed and 24 studies were included. Studies showed at least 20% of children with TBI had some degree of SWD including trouble falling or staying asleep, fatigue, daytime fatigue, and nightmares. SWD was negatively correlated with cognitive, behavioral, and quality of life outcomes. There was moderate-high risk of bias for all studies due to small sample size and lack of validated or objective SWD measures.
Citation: Luther M, Poppert Cordts KM, Williams CN . Sleep disturbances after pediatric traumatic brain injury: a systematic review of prevalence, risk factors, and association with recovery. Sleep 2020 Oct;43(10):zsaa083. doi: 10.1093/sleep/zsaa083..
Keywords: Children/Adolescents, Sleep Problems, Brain Injury, Neurological Disorders, Trauma, Risk, Patient-Centered Outcomes Research, Outcomes, Quality of Life, Evidence-Based Practice
Otto L, Wang A, Wheeler K
Comparison of manual and computer assigned injury severity scores.
The study objective was to compare the ISS manually assigned by hospital personnel and those generated by the ICDPIC software for value agreement and predictive power of length of stay (LOS) and mortality. The investigators found that the LOS and mortality predictive power were significantly higher for manually assigned ISS when compared with computer assigned ISS in both PTC and NTDB data sets. They indicated that hospitals should be cautious about transitioning to computer assigned ISS, specifically for patients who are critically injured.
Citation: Otto L, Wang A, Wheeler K . Comparison of manual and computer assigned injury severity scores. Inj Prev 2020 Aug;26(4):330-33. doi: 10.1136/injuryprev-2019-043224..
Keywords: Health Information Technology (HIT), Injuries and Wounds, Trauma, Hospitals
Johnson BN, Lumley MA, Cheavens JS
Exploring the links among borderline personality disorder symptoms, trauma, and pain in patients with chronic pain disorders.
The authors compared study participants high or low on borderline personality disorder (BPD) symptoms on patterns of pain experience and types of child and adult traumas. They found that BPD symptoms were associated with increased clinical severity among patients with chronic pain as well as a unique manifestation of pain experiencing. Childhood trauma of all types is associated with chronic pain and BPD co-occurrence. They recommended that researchers and clinicians assess for BPD in people with chronic pain to enhance conceptual models of the transaction between these disorders and to improve clinical care.
Citation: Johnson BN, Lumley MA, Cheavens JS . Exploring the links among borderline personality disorder symptoms, trauma, and pain in patients with chronic pain disorders. J Psychosom Res 2020 Aug;135:110164. doi: 10.1016/j.jpsychores.2020.110164..
Keywords: Behavioral Health, Trauma, Pain, Chronic Conditions
Darling KE, Ranzenhofer LM, Hadley W
Negative childhood experiences and disordered eating in adolescents in a weight management program: the role of depressive symptoms.
This cross-sectional study examined the association between stressful life events and weight-related outcomes including weight status, disordered eating behaviors, and insulin sensitivity in treatment-seeking adolescents with overweight and obesity. The authors were also looking at the potential mediating role of depression. The study included 170 adolescents (mean age 14.8, 62% female) enrolled in an interdisciplinary weight management program. Findings were that stressful childhood experiences were significantly related to weight status and disordered eating but not insulin sensitivity. Depressive symptoms were related to stressful experiences and disordered eating patterns but not weight status or insulin sensitivity.
Citation: Darling KE, Ranzenhofer LM, Hadley W . Negative childhood experiences and disordered eating in adolescents in a weight management program: the role of depressive symptoms. Eat Behav 2020 Aug;38:101402. doi: 10.1016/j.eatbeh.2020.101402..
Keywords: Children/Adolescents, Obesity: Weight Management, Obesity, Stress, Depression, Behavioral Health, Trauma
Porter A, Brown CC, Tilford JM
Association of insurance status with treatment and outcomes in pediatric patients with severe traumatic brain injury.
This study’s objective was to determine if a health insurance disparity exists among pediatric patients with severe traumatic brain injury using data from the National Trauma Data Bank. The Bank contains data from more than 800 trauma centers in the United States. Isolated traumatic brain injury was defined as patients with a head Abbreviated Injury Scale score of 3+. Procedure codes were used to identify four primary treatment approaches combined into 2 classifications: craniotomy or craniectomy and external or intracranial ventricular draining. Condition at admission was defined including hypotension, Glasgow Coma Scale, mechanism and intent of injury, and Injury Severity Scale. Among the cohort of 12,449 patients, 91% had insurance and 9% were uninsured. Children without insurance had worse condition at admission with higher rates of hypotension and higher Injury Severity Score when compared with publicly and privately insured patients. Having insurance was associated with a 32% increase in the odds of cranial procedures, and 54% increase in the odds of monitor placement. Insurance coverage was associated 25% lower odds of inpatient mortality. Further study is needed to determine what factors lead to worse condition at admission.
Citation: Porter A, Brown CC, Tilford JM . Association of insurance status with treatment and outcomes in pediatric patients with severe traumatic brain injury. Crit Care Med 2020 Jul;48(7):e584-e91. doi: 10.1097/ccm.0000000000004398..
Keywords: Children/Adolescents, Brain Injury, Trauma, Health Insurance, Access to Care, Uninsured, Outcomes
Morris RS, Davis NJ, Koestner A
Redefining the trauma triage matrix: the role of emergent interventions.
In this retrospective study, researchers compared the effectiveness of the need for an emergent intervention within 6 h (NEI-6) with existing definitions. Using data from the Michigan Trauma Quality Improvement Program, they found that NEI-6 performs better than trauma triage matrix, need for trauma intervention, and secondary triage assessment tool in terms of under-triage, mortality and need for resource utilization. Other methods resulted in significantly more full-tiered trauma team activations than NEI-6 without identifying patients at risk for early mortality. They concluded that NEI-6 represents a novel tool to determine trauma activation appropriateness.
Citation: Morris RS, Davis NJ, Koestner A . Redefining the trauma triage matrix: the role of emergent interventions. J Surg Res 2020 Jul;251:195-201. doi: 10.1016/j.jss.2019.11.011..
Keywords: Trauma, Emergency Department, Healthcare Delivery
Tignanelli CJ, Silverman GM, Lindemann EA
Natural language processing of prehospital emergency medical services trauma records allows for automated characterization of treatment appropriateness.
Incomplete prehospital trauma care is a significant contributor to preventable deaths. Current databases lack timelines easily constructible of clinical events. Temporal associations and procedural indications are critical to characterize treatment appropriateness. Natural language processing (NLP) methods present a novel approach to bridge this gap. In this study, the investigators sought to evaluate the efficacy of a novel and automated NLP pipeline to determine treatment appropriateness from a sample of prehospital EMS motor vehicle crash records.
Citation: Tignanelli CJ, Silverman GM, Lindemann EA . Natural language processing of prehospital emergency medical services trauma records allows for automated characterization of treatment appropriateness. J Trauma Acute Care Surg 2020 May;88(5):607-14. doi: 10.1097/ta.0000000000002598.
Keywords: Trauma, Injuries and Wounds, Electronic Health Records (EHRs), Health Information Technology (HIT), Quality Improvement, Quality of Care
Myers SR, DeSimone JD, Lorch SA
US hospital type and proximity to mass shooting events.
This study used data on mass shootings to examine the proximity of adult trauma centers, pediatric trauma centers (TCs), and non–trauma center hospitals to such events. The investigators concluded that based on the data, to ensure the success of trauma care everywhere, all hospitals regardless of TC status should expect and prepare for the eventuality of a mass-casualty event involving both adults and children. All hospitals must be ready to serve as the combat forward-field hospital.
Citation: Myers SR, DeSimone JD, Lorch SA . US hospital type and proximity to mass shooting events. JAMA Surg 2020 May;155(5):446-7. doi: 10.1001/jamasurg.2020.0095..
Keywords: Hospitals, Trauma, Emergency Department, Emergency Preparedness
Wooldridge AR, Carayon P, Hoonakker P
Work system barriers and facilitators in inpatient care transitions of pediatric trauma patients.
Hospital-based care of pediatric trauma patients includes transitions between units that are critical for quality of care and patient safety. Using a macroergonomics approach, the investigators identified work system barriers and facilitators in care transitions. They interviewed eighteen healthcare professionals involved in transitions from emergency department (ED) to operating room (OR), OR to pediatric intensive care unit (PICU) and ED to PICU.
Citation: Wooldridge AR, Carayon P, Hoonakker P . Work system barriers and facilitators in inpatient care transitions of pediatric trauma patients. Appl Ergon 2020 May;85:103059. doi: 10.1016/j.apergo.2020.103059..
Keywords: Children/Adolescents, Inpatient Care, Transitions of Care, Healthcare Delivery, Trauma, Hospitals
Morris RS, Milia D, Glover J
Predictors of elderly mortality after trauma: a novel outcome score.
Elderly trauma patients are at high risk for mortality, even when presenting with minor injuries. Previous prognostic models are poorly used because of their reliance on elements unavailable during the index hospitalization. The purpose of this study was to develop a predictive algorithm to accurately estimate in-hospital mortality using easily available metrics. A two-tiered scoring system to predict in-hospital mortality was developed: a quick elderly mortality after trauma (qEMAT) score for use at initial patient presentation and a full EMAT (fEMAT) score for use after radiologic evaluation.
Citation: Morris RS, Milia D, Glover J . Predictors of elderly mortality after trauma: a novel outcome score. J Trauma Acute Care Surg 2020 Mar;88(3):416-24. doi: 10.1097/ta.0000000000002569..
Keywords: Elderly, Mortality, Trauma, Injuries and Wounds
Williams CN, Hartman ME, McEvoy CT
Sleep-wake disturbances after acquired brain injury in children surviving critical care.
Sleep-wake disturbances are underevaluated among children with acquired brain injury surviving critical care. In this prospective cohort study, the investigators aimed to quantify severity, phenotypes, and risk factors for sleep-wake disturbances. The investigators concluded that over half of children surviving critical care with acquired brain injury have sleep-wake disturbances. They indicated that many sleep-wake disturbances phenotypes were identified, but most children had disturbance in initiation and maintenance of sleep.
Citation: Williams CN, Hartman ME, McEvoy CT . Sleep-wake disturbances after acquired brain injury in children surviving critical care. Pediatr Neurol 2020 Feb;103:43-51. doi: 10.1016/j.pediatrneurol.2019.08.010..
Keywords: Children/Adolescents, Brain Injury, Critical Care, Sleep Problems, Trauma, Injuries and Wounds, Neurological Disorders
Fernandez R, Rosenman ED, Olenick J
Simulation-based team leadership training improves team leadership during actual trauma resuscitations: a randomized controlled trial.
This study’s objective was to assess the clinical impact of simulation-based leadership training on team leadership and patient care during trauma resuscitations. A total of 79 second- and third-year residents at the Harborview Medical Center (a level 1 trauma center) were randomized and 360 resuscitations were analyzed. Participant-led actual trauma resuscitations were video recorded and then coded for leadership behaviors and patient care. Then the residents were randomized to a 4-hour simulation-based leadership training (intervention) or standard orientation (control) condition. The leadership behaviors were then scored pre- and post-training. There was a significant difference in post-training leadership behaviors between the intervention and control conditions.
Citation: Fernandez R, Rosenman ED, Olenick J . Simulation-based team leadership training improves team leadership during actual trauma resuscitations: a randomized controlled trial. Crit Care Med 2020 Jan;48(1):73-82. doi: 10.1097/ccm.0000000000004077..
Keywords: Teams, Trauma, Simulation, Training, Provider
Rudd BN, Last BS, Gregor C
Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy.
The objectives of the current study are to (a) evaluate the effectiveness of trauma-focused cognitive behavioral therapy (TF-CBT) delivered from 2013 to 2016 in 15 behavioral health agencies on youth PTSD as well as general mental health symptoms and functioning, and (b) benchmark these clinical outcomes against other published efficacy and effectiveness trials. This study is the first benchmarking study of TF-CBT and provides preliminary findings with regard to the effectiveness, and transportability, of TF-CBT to urban community settings that serve youth in poverty.
Citation: Rudd BN, Last BS, Gregor C . Benchmarking treatment effectiveness of community-delivered trauma-focused cognitive behavioral therapy. Am J Community Psychol 2019 Dec;64(3-4):438-50. doi: 10.1002/ajcp.12370..
Keywords: Children/Adolescents, Behavioral Health, Trauma, Stress, Outcomes, Treatments
Kim J, Engelberg RA, Downey L
Predictors of advance care planning documentation in patients with underlying chronic illness who died of traumatic injury.
This study examined predictors of advance care planning (ACP) in patients with underlying chronic illness who died of traumatic injury. Death records and electronic health records were used to identify decedents with chronic life-limiting illness who died between 2010 and 2015. Only 22% of decedents at ACP documentation at the time of their traumatic injury. Patients who were older, had more chronic illnesses and more nonsurgical hospitalizations were more likely to have completed ACP documentation in the year before injury. After injury, only 4% completed ACP documentation who did not have it before.
Citation: Kim J, Engelberg RA, Downey L . Predictors of advance care planning documentation in patients with underlying chronic illness who died of traumatic injury. J Pain Symptom Manage 2019 Nov;58(5):857-63.e1. doi: 10.1016/j.jpainsymman.2019.07.015..
Keywords: Patient-Centered Healthcare, Trauma, Chronic Conditions