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A population based study of hospitalised seriously injured in a region of Northern Italy

BACKGROUND: Injury is a public health problem in terms of mortality, morbidity and disability. The implementation of a regionalised trauma system has been proved to significantly reduce the social impact of severe trauma on population. A population-based registry may be useful to obtain reliable epi...

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Autores principales: Chiara, Osvaldo, Mazzali, Cristina, Lelli, Sofia, Mariani, Anna, Cimbanassi, Stefania
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3751444/
https://www.ncbi.nlm.nih.gov/pubmed/23937969
http://dx.doi.org/10.1186/1749-7922-8-32
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author Chiara, Osvaldo
Mazzali, Cristina
Lelli, Sofia
Mariani, Anna
Cimbanassi, Stefania
author_facet Chiara, Osvaldo
Mazzali, Cristina
Lelli, Sofia
Mariani, Anna
Cimbanassi, Stefania
author_sort Chiara, Osvaldo
collection PubMed
description BACKGROUND: Injury is a public health problem in terms of mortality, morbidity and disability. The implementation of a regionalised trauma system has been proved to significantly reduce the social impact of severe trauma on population. A population-based registry may be useful to obtain reliable epidemiologic data. AIM: To perform an exhaustive analysis of severe trauma patients hospitalised in Lombardia, a region of northern Italy. MATERIALS AND METHODS: The regional Hospital Discharge Registry (HDR) was used to retrieve data of all patients who suffered from serious injuries from 2008 to 2010. ICD9-CM codes of discharge diagnoses were analysed and patients coded from 800.0 to 939.9 or from 950.0 to 959.9 have been retrieved. Femur fractures in elderly and patients with length of hospital stay less than 2 days were excluded. Patients have been considered seriously injured if discharged dead or any of followings: admission or transit in ICU, need of mechanical ventilation, tracheotomy, invasive hemodynamic monitoring. Average reimbursement based on DRG has been evaluated. STATISTICS: Student’s t test, ANOVA for continuous data, chi-square test for categorical data were used, and a p value less than 0.05 was considered significant. RESULTS: The severely injured patients hospitalised in Lombardia in three years were 11704, 391 per million per year. Overall mortality was 24.17% and increased with age. Males aging from 18 to 64 years had more occupational injuries, trauma on the road and violence by others. Females were more susceptible to domestic injuries and self inflicted violence, mostly in older ages. Acute mortality was higher after traffic accidents, while late mortality was increased in domestic trauma. Pediatric cases were unusual. A significant increase (+10.18%) in domestic trauma, with a concomitant decrease (-17.76%) in road-related accidents was observed in the three years study period. Reimbursement paid to hospitals for seriously injured was insufficient with regard to estimated costs of care. CONCLUSION: Serious injury requiring hospitalisation in Lombardia is still an healthcare problem, with a trend toward a decrease of traffic accidents, increase in domestic trauma and involvement of older people. These results may help to plan a new regionalised Trauma System.
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spelling pubmed-37514442013-08-24 A population based study of hospitalised seriously injured in a region of Northern Italy Chiara, Osvaldo Mazzali, Cristina Lelli, Sofia Mariani, Anna Cimbanassi, Stefania World J Emerg Surg Research Article BACKGROUND: Injury is a public health problem in terms of mortality, morbidity and disability. The implementation of a regionalised trauma system has been proved to significantly reduce the social impact of severe trauma on population. A population-based registry may be useful to obtain reliable epidemiologic data. AIM: To perform an exhaustive analysis of severe trauma patients hospitalised in Lombardia, a region of northern Italy. MATERIALS AND METHODS: The regional Hospital Discharge Registry (HDR) was used to retrieve data of all patients who suffered from serious injuries from 2008 to 2010. ICD9-CM codes of discharge diagnoses were analysed and patients coded from 800.0 to 939.9 or from 950.0 to 959.9 have been retrieved. Femur fractures in elderly and patients with length of hospital stay less than 2 days were excluded. Patients have been considered seriously injured if discharged dead or any of followings: admission or transit in ICU, need of mechanical ventilation, tracheotomy, invasive hemodynamic monitoring. Average reimbursement based on DRG has been evaluated. STATISTICS: Student’s t test, ANOVA for continuous data, chi-square test for categorical data were used, and a p value less than 0.05 was considered significant. RESULTS: The severely injured patients hospitalised in Lombardia in three years were 11704, 391 per million per year. Overall mortality was 24.17% and increased with age. Males aging from 18 to 64 years had more occupational injuries, trauma on the road and violence by others. Females were more susceptible to domestic injuries and self inflicted violence, mostly in older ages. Acute mortality was higher after traffic accidents, while late mortality was increased in domestic trauma. Pediatric cases were unusual. A significant increase (+10.18%) in domestic trauma, with a concomitant decrease (-17.76%) in road-related accidents was observed in the three years study period. Reimbursement paid to hospitals for seriously injured was insufficient with regard to estimated costs of care. CONCLUSION: Serious injury requiring hospitalisation in Lombardia is still an healthcare problem, with a trend toward a decrease of traffic accidents, increase in domestic trauma and involvement of older people. These results may help to plan a new regionalised Trauma System. BioMed Central 2013-08-12 /pmc/articles/PMC3751444/ /pubmed/23937969 http://dx.doi.org/10.1186/1749-7922-8-32 Text en Copyright ©2013 Chiara et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Chiara, Osvaldo
Mazzali, Cristina
Lelli, Sofia
Mariani, Anna
Cimbanassi, Stefania
A population based study of hospitalised seriously injured in a region of Northern Italy
title A population based study of hospitalised seriously injured in a region of Northern Italy
title_full A population based study of hospitalised seriously injured in a region of Northern Italy
title_fullStr A population based study of hospitalised seriously injured in a region of Northern Italy
title_full_unstemmed A population based study of hospitalised seriously injured in a region of Northern Italy
title_short A population based study of hospitalised seriously injured in a region of Northern Italy
title_sort population based study of hospitalised seriously injured in a region of northern italy
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3751444/
https://www.ncbi.nlm.nih.gov/pubmed/23937969
http://dx.doi.org/10.1186/1749-7922-8-32
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