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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.
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1 to 19 of 19 Research Studies DisplayedNeiman PU, Flaherty MM, Salim A
Evaluating the complex association between social vulnerability index and trauma mortality.
Researchers merged CDC Social Vulnerability Index (SVI) data with a statewide trauma registry and employed three analytic models to evaluate the association between SVI quartile and inpatient trauma mortality. Results showed that, while higher SVI was associated with worse mortality in the unadjusted model, there was no significant association between SVI and inpatient mortality after adjusting for covariates common to trauma. Higher SVI was associated with a higher likelihood of presenting with penetrating injuries. These findings suggested that the burden of trauma mortality is not driven by variation in quality of treatment, but by lethality of injuries. The researchers concluded that improvement in trauma survival among high-risk communities will require interventions and policies which target social and structural inequities upstream of trauma center admission.
AHRQ-funded; HS028672; HS027788.
Citation: Neiman PU, Flaherty MM, Salim A .
Evaluating the complex association between social vulnerability index and trauma mortality.
J Trauma Acute Care Surg 2022 May; 92(5):821-30. doi: 10.1097/ta.0000000000003514..
Keywords: Social Determinants of Health, Mortality
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: Medication, Risk, Mortality
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.
AHRQ-funded; HS026379.
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, Injuries and Wounds
Albrecht JS, Al Kibria GM, Greene CR
Post-discharge mortality of older adults with traumatic brain injury or other trauma.
This study examined post-discharge mortality of older adults with traumatic brain injury (TBI) or non-TBI trauma compared with the general population. A retrospective cohort study of adults 65 years and older was conducted using data from an urban trauma center from 1997 to 2008. The data was then linked to the National Death Index through 2008 to obtain date and cause of death. A higher rate of death was associated with both cohorts after moderate to severe injury from accidents than for older adults without TBI or non-TBI trauma.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Al Kibria GM, Greene CR .
Post-discharge mortality of older adults with traumatic brain injury or other trauma.
J Am Geriatr Soc 2019 Jul 25;67(11):2382-86. doi: 10.1111/jgs.16098..
Keywords: Elderly, Hospital Discharge, Injuries and Wounds, Mortality
Meagher AD, Lin A, Mandell SP
A comparison of scoring systems for predicting short- and long-term survival after trauma in older adults.
Researchers conducted a retrospective cohort study to identify injured older adults at highest risk for 30-day mortality. They found that older, injured adults transported by EMS to a large variety of trauma and non-trauma hospitals were more likely to die within 30 days if they required emergent airway management or had a higher comorbidity burden. They concluded that identification of an ideal prognostic tool remains elusive.
AHRQ-funded; HS023796.
Citation: Meagher AD, Lin A, Mandell SP .
A comparison of scoring systems for predicting short- and long-term survival after trauma in older adults.
Acad Emerg Med 2019 Jun;26(6):621-30. doi: 10.1111/acem.13727..
Keywords: Elderly, Mortality, Injuries and Wounds, Emergency Department
Jarman MP, Pollack Porter K, Curriero FC
Factors mediating demographic determinants of injury mortality.
The authors investigated the role of injury characteristics and access to trauma care as mediators of the relationships between race, ethnicity, sex, and injury mortality. They found that distance, injury characteristics, and insurance mediate the effects of demographic characteristics on injury mortality and appear to contribute to disparities in injury mortality.
AHRQ-funded; HS000029.
Citation: Jarman MP, Pollack Porter K, Curriero FC .
Factors mediating demographic determinants of injury mortality.
Ann Epidemiol 2019 Jun;34:58-64.e2. doi: 10.1016/j.annepidem.2019.03.013..
Keywords: Access to Care, Disparities, Injuries and Wounds, Mortality, Racial and Ethnic Minorities, Sex Factors, Social Determinants of Health
Albrecht JS, Al Kibria G, Gruber-Baldini A
Risk of mortality in individuals with hip fracture and traumatic brain injury.
Researchers estimated the prevalence of TBI (traumatic brain injury) with individuals hospitalized with hip fracture and their all-cause mortality. The population studied were Medicare beneficiaries aged 65 and older from 2006 to 2010. They concluded that there was a higher risk of death with individuals who had TBI than those who had only a hip fracture.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Al Kibria G, Gruber-Baldini A .
Risk of mortality in individuals with hip fracture and traumatic brain injury.
J Am Geriatr Soc 2019 Jan;67(1):124-27. doi: 10.1111/jgs.15661..
Keywords: Brain Injury, Injuries and Wounds, Mortality, Risk
Shi J, Shen J, Caupp S
A new weighted injury severity scoring system: Better predictive power for pediatric trauma mortality.
The objective of this study was to develop a weighted Injury Severity Score (wISS) system for pediatric blunt trauma patients with better predictive power than ISS. The authors suggest that by weighting the Abbreviated Injury Scale from different body regions, the wISS had significantly better predictive power for mortality than the ISS, especially in critically injured children.
AHRQ-funded; HS024263.
Citation: Shi J, Shen J, Caupp S .
A new weighted injury severity scoring system: Better predictive power for pediatric trauma mortality.
J Trauma Acute Care Surg 2018 Aug;85(2):334-40. doi: 10.1097/ta.0000000000001943..
Keywords: Children/Adolescents, Injuries and Wounds, Mortality, Children/Adolescents
Jarman MP, Haut ER, Curriero FC
Mapping areas with concentrated risk of trauma mortality: a first step toward mitigating geographic and socioeconomic disparities in trauma.
This study sought to classify injury event locations based on features of the built and social environment at the injury scene, and to examine patterns in individual patient demographics, injury characteristics, and mortality by location class. The investigators concluded identification of location classes may be useful for targeted primary prevention and treatment interventions, both by identifying geographic areas with the highest risk of injury mortality and by identifying patterns of individual risk within location classes.
AHRQ-funded; HS000029.
Citation: Jarman MP, Haut ER, Curriero FC .
Mapping areas with concentrated risk of trauma mortality: a first step toward mitigating geographic and socioeconomic disparities in trauma.
J Trauma Acute Care Surg 2018 Jul;85(1):54-61. doi: 10.1097/ta.0000000000001883..
Keywords: Disparities, Injuries and Wounds, Mortality, Social Determinants of Health
Sakran JV, Mehta A, Fransman R
Nationwide trends in mortality following penetrating trauma: are we up for the challenge?
This study analyzed contemporary trends in pre-hospital mortality from penetrating trauma in the past decade using The National Trauma Data Bank. The authors concluded the odds of pre-hospital mortality has increased over 4-fold for gunshot wounds and almost 9-fold for stab wounds. Examining violence intensity, along with improvements in hospital care and data collection, may explain these findings.
AHRQ-funded; HS024547.
Citation: Sakran JV, Mehta A, Fransman R .
Nationwide trends in mortality following penetrating trauma: are we up for the challenge?
J Trauma Acute Care Surg 2018 Jul;85(1):160-66. doi: 10.1097/ta.0000000000001907..
Keywords: Injuries and Wounds, Mortality, Outcomes
Jarman MP, Curriero FC, Haut ER
Associations of distance to trauma care, community income, and neighborhood median age with rates of injury mortality.
The purpose of this study was to examine the association of injury scene characteristics with injury mortality. The study concluded that injury scene characteristics are associated with injury mortality. The authors found that odds of death are highest for patients injured in communities with higher median age or lower per capita income and at locations farthest from level 1 or 2 trauma centers.
AHRQ-funded; HS000029.
Citation: Jarman MP, Curriero FC, Haut ER .
Associations of distance to trauma care, community income, and neighborhood median age with rates of injury mortality.
JAMA Surg 2018 Jun;153(6):535-43. doi: 10.1001/jamasurg.2017.6133..
Keywords: Access to Care, Mortality, Social Determinants of Health, Injuries and Wounds
Albrecht JS, McCunn M, Stein DM
Sex differences in mortality following isolated traumatic brain injury among older adults.
This retrospective cohort study's objective was to determine the possibility of sex differences in mortality among older adutls following isolated traumatic brain injury (TBI) and to comapre with findings using all TBI. The researchers did not find that women were significantly associated with decreased odds of mortality following isolated TBI.
AHRQ-funded; HS024560.
Citation: Albrecht JS, McCunn M, Stein DM .
Sex differences in mortality following isolated traumatic brain injury among older adults.
J Trauma Acute Care Surg 2016 Sep;81(3):486-92. doi: 10.1097/ta.0000000000001118.
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Keywords: Sex Factors, Brain Injury, Mortality, Elderly
Shaw JJ, Psoinos CM, Santry HP
It's all about location, location, location: A new perspective on trauma transport.
The objective of this study was to determine the effect of aeromedical transport on trauma mortality when accounting for geographic factors. It concluded that helicopter transport does not impart a survival benefit for trauma patients when geographic considerations are taken into account.
AHRQ-funded; HS022694.
Citation: Shaw JJ, Psoinos CM, Santry HP .
It's all about location, location, location: A new perspective on trauma transport.
Ann Surg 2016 Feb;263(2):413-8. doi: 10.1097/sla.0000000000001265..
Keywords: Emergency Medical Services (EMS), Registries, Mortality, Access to Care
Newgard CD, Lowe RA
Cost savings in trauma systems: The devil's in the details.
The authors comment on an article in the same issue of Annals by Zocchi et al. They argue that it makes an important contribution to trauma research and health policy by addressing the question: Can we potentially save money in trauma systems without compromising outcomes by redirecting patients with minor to moderate injuries away from major trauma centers?
AHRQ-funded; HS023796.
Citation: Newgard CD, Lowe RA .
Cost savings in trauma systems: The devil's in the details.
Ann Emerg Med 2016 Jan;67(1):68-70. doi: 10.1016/j.annemergmed.2015.06.025..
Keywords: Healthcare Costs, Mortality, Care Coordination, Injuries and Wounds
Vickers BP, Shi J, Lu B
Comparative study of ED mortality risk of US trauma patients treated at level I and level II vs nontrauma centers.
The researchers used National Emergency Department Sample (NEDS) data to explore the hypothesis that severely injured trauma victims properly triaged to a level I or level II trauma center have significantly lower odds of death than those undertriaged to a non-trauma center. They found that trauma patients with Injury Severity Score of greater than 25 received most benefit from proper triage. Efforts to reduce undertriage should focus on this population.
AHRQ-funded; HS022277.
Citation: Vickers BP, Shi J, Lu B .
Comparative study of ED mortality risk of US trauma patients treated at level I and level II vs nontrauma centers.
Am J Emerg Med 2015 Sep;33(9):1158-65. doi: 10.1016/j.ajem.2015.05.010..
Keywords: Healthcare Cost and Utilization Project (HCUP), Emergency Department, Comparative Effectiveness, Mortality
Jenkins PC, Richardson CR, Norton EC
Trauma surge index: advancing the measurement of trauma surges and their influence on mortality.
The authors developed a new measure of hospital capacity strain corresponding to trauma admissions and examined the relationship between trauma surges and inpatient mortality. Their Trauma Surge Index (TSI) method can be implemented by hospitals and trauma systems to examine periods of high-capacity strain retrospectively, identify specific resources that might have been needed, and better direct future investments in an evidence-based manner.
AHRQ-funded; HS020672.
Citation: Jenkins PC, Richardson CR, Norton EC .
Trauma surge index: advancing the measurement of trauma surges and their influence on mortality.
J Am Coll Surg 2015 Sep;221(3):729-38.e1. doi: 10.1016/j.jamcollsurg.2015.05.016.
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Keywords: Emergency Preparedness, Hospitals, Injuries and Wounds, Mortality
Peng J, Wheeler K, Shi J
Trauma with Injury Severity Score of 75: are these unsurvivable injuries?
This study aimed to assess the true mortality among patients with an ISS=75, and to examine the characteristics and primary diagnoses of these patients. Its results revealed that at least half of patients with an ISS=75 survived, demonstrating that the rationale for excluding patients with an ISS=75 from analysis is not always justified.
AHRQ-funded; HS022277.
Citation: Peng J, Wheeler K, Shi J .
Trauma with Injury Severity Score of 75: are these unsurvivable injuries?
PLoS One 2015 Jul 31;10(7):e0134821. doi: 10.1371/journal.pone.0134821..
Keywords: Mortality, Healthcare Cost and Utilization Project (HCUP), Emergency Medical Services (EMS), Emergency Department
Sherry MK, Mossallam M, Mulligan M
Rates of intentionally caused and road crash deaths of US citizens abroad.
The researchers invetigated rates of death by cause and country among US travellers to aid in the development of risk reduction strategies. Using data from January 2003 to December 2009 from the US Department of State's Bureau of Consular Affairs and from the US Department of Commerce's Office of Travel and Tourism, they found that the leading cause of non-natural deaths in US travellers abroad was road crashes, which exceeds intentional injury as the leading cause of non-natural deaths in almost every country where US citizens travel.
AHRQ-funded; HS000029.
Citation: Sherry MK, Mossallam M, Mulligan M .
Rates of intentionally caused and road crash deaths of US citizens abroad.
Inj Prev 2015 Apr;21(e1):e10-4. doi: 10.1136/injuryprev-2013-040923.
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Keywords: Injuries and Wounds, Mortality, Risk
Band RA, Salhi RA, Holena DN
Severity-adjusted mortality in trauma patients transported by police.
Two decades ago, Philadelphia began allowing police transport of patients with penetrating trauma. In this retrospective cohort study, the investigators conduct a large, multiyear, citywide analysis of this policy. They examine the association between mode of out-of-hospital transport (police department versus emergency medical services [EMS]) and mortality among patients with penetrating trauma in Philadelphia.
AHRQ-funded; HS017960.
Citation: Band RA, Salhi RA, Holena DN .
Severity-adjusted mortality in trauma patients transported by police.
Ann Emerg Med 2014 May;63(5):608-14.e3. doi: 10.1016/j.annemergmed.2013.11.008..
Keywords: Injuries and Wounds, Mortality, Patient-Centered Outcomes Research
