Association of Hospital-Level Intensive Care Unit Use and Outcomes in Older Patients With Isolated Rib Fractures

JAMA Network Open
Jessica A BowmanGarth H Utter

Abstract

The optimal level of care for older patients with rib fractures as an isolated injury is unknown. To characterize interhospital variability in intensive care unit (ICU) vs non-ICU admission of older patients with isolated rib fractures and to evaluate whether greater hospital-level use of ICU admission is associated with improved outcomes. This cohort study included trauma patients aged 65 years and older with isolated rib fractures who were admitted to US trauma centers participating in the National Trauma Data Bank between January 1, 2015, and December 31, 2016. Patients were excluded if they had other significant injuries, were intubated or had assisted respirations in the emergency department (ED), or had a Glasgow Coma Scale (GCS) score of less than 9 in the ED. Hospitals with fewer than 10 eligible patients were excluded. Data analysis was conducted from May 2019 through September 2020. Admission to the ICU. Composite of unplanned intubation, pneumonia, or death during hospitalization. Among 23 951 patients (11 066 [46.2%] women; mean [SD] age, 77.0 [7.2] years) at 573 hospitals, the median (interquartile range) proportion of ICU use was 16.7% (7.4%-32.0%), but this varied from a low of 0% to a high of 91.9%. The composit...Continue Reading

References

Jun 24, 2000·The Journal of Trauma·E M BulgerG J Jurkovich
Mar 14, 2003·The Journal of Trauma·Eric BergeronMarcel Martin
May 19, 2010·Archives of Surgery·David T HarringtonUNKNOWN Research Consortium of New England Centers for Trauma (ReCONECT)
May 9, 2012·Critical Care Medicine·Hayley B GershengornHannah Wunsch
Jun 12, 2012·The Journal of Surgical Research·Angela LeTerence O'Keeffe
Sep 23, 2014·Surgery·Jennifer ChenR Stephen Smith
Apr 25, 2015·The Journal of Trauma and Acute Care Surgery·Katherine W GonzalezJustin L Regner
Aug 27, 2015·The Journal of Trauma and Acute Care Surgery·Thomas W CarverJasmeet Paul
Sep 24, 2015·JAMA : the Journal of the American Medical Association·Thomas S ValleyColin R Cooke
Dec 20, 2015·The Journal of Trauma and Acute Care Surgery·Brandon C ChapmanFredric M Pieracci
Aug 16, 2016·Critical Care Medicine·Andrew J AdmonColin R Cooke
Oct 26, 2016·The Journal of Trauma and Acute Care Surgery·Karen J BraselWalter L Biffl
Oct 4, 2017·JAMA : the Journal of the American Medical Association·Bertrand GuidetUNKNOWN ICE-CUB 2 Study Network
Oct 29, 2017·The Journal of Surgical Research·Owen J PykeRandeep S Jawa
Jun 28, 2018·JAMA : the Journal of the American Medical Association·Joan M TenoVincent Mor
Jul 15, 2018·BMC Health Services Research·Maria SchubertAlain Rudiger
Aug 7, 2018·The Journal of Trauma and Acute Care Surgery·Rachel WarnerAlison Wilson
Aug 26, 2019·The Journal of Surgical Research·Jessica A BowmanGarth H Utter
Jan 11, 2020·The Journal of Trauma and Acute Care Surgery·Jessica A BowmanGarth H Utter

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