Citation

Albaaj H, Attergrim J, Strömmer L, Brattström O, Jacobsson M, Wihlke G, Västerbo L, Joneborg E, Gerdin Wärnberg M. Scand. J. Trauma Resusc. Emerg. Med. 2023; 31(1): e87.

Copyright

(Copyright © 2023, Scandinavian Networking Group on Trauma and Emergency Management, Publisher Holtzbrinck Springer Nature Publishing Group - BMC)

DOI

10.1186/s13049-023-01157-y

PMID

38012791

PMCID

PMC10680227

Abstract

BACKGROUND: Trauma is one of the leading causes of morbidity and mortality worldwide. Morbidity and mortality review of selected patient cases is used to improve the quality of trauma care by identifying opportunities for improvement (OFI). The aim of this study was to assess how patient and process factors are associated with OFI in trauma care.

METHODS: We conducted a registry-based study using all patients between 2017 and 2021 from the Karolinska University Hospital who had been reviewed regarding the presence of OFI as defined by a morbidity and mortality conference. We used bi- and multivariable logistic regression to assess the associations between the following patient and process factors and OFI: age, sex, respiratory rate, systolic blood pressure, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), survival at 30 days, highest hospital care level, arrival on working hours, arrival on weekends, intubation status and time to first computed tomography (CT).

RESULTS: OFI was identified in 300 (5.8%) out of 5182 patients. Age, missing Glasgow Coma Scale, time to first CT, highest hospital care level and ISS were statistically significantly associated with OFI.

CONCLUSION: Several patient and process factors were found to be associated with OFI, indicating that patients with moderate to severe trauma and those with delays to first CT are at the highest odds of OFI.

Language: en

Keywords

Humans; Trauma; Logistic Models; Injury Severity Score; Retrospective Studies; Glasgow Coma Scale; Trauma care; *Emergency Medical Services; *Wounds and Injuries/therapy; Acute surgery; Opportunities for improvement; Registries