Citation

Falor A, Kim D, Bricker S, Neville A, Bongard FS, Putnam B, Plurad D. J. Surg. Res. 2014; 188(1): 238-242.

Affiliation

Division of Trauma-Acute Care Surgery and Surgical Critical Care, Department of Surgery, Harbor-UCLA, Medical Center, Torrance, California. Electronic address: dsplurad@yahoo.com.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.jss.2013.12.003

PMID

24405611

Abstract

BACKGROUND: The purpose of this study was to investigate the relationship between insurance status and outcomes for trauma patients presenting without vital signs undergoing urgent intervention.

MATERIALS AND METHODS: The National Trauma Data Bank was queried for patients presenting with a systolic blood pressure equal to zero and a Glasgow Coma Scale score of three ("clinically dead"), who underwent urgent thoracotomy and-or laparotomy (UTL). Insured patients were compared with uninsured (INS [-]) patients.

RESULTS: There were 18,171 patients presenting clinically dead having a payment source documented. INS (-) patients were more likely to undergo UTL (5.4% [416-7704] versus 2.7% [285-10,467], 1.481 [1.390-1.577], <0.001). Out of 689 patients who underwent UTL and meeting inclusion criteria, 416 (60.4%) were INS (-). Patients with insurance demonstrated a significantly greater survival (9.9% [27-273] versus 1.7% [7-416], 5.878 [2.596-13.307] P < 0.001). Adjusting for mechanism, race, age, injury severity, and comorbidities, insured status was independently associated with survival.

CONCLUSIONS: The presence of health insurance is independently associated with survival in trauma patients presenting with cardiovascular collapse who undergo urgent surgical intervention.

Language: en