Does the time of the day affect multiple trauma care in hospitals? A retrospective analysis of data from the TraumaRegister DGU®
Dublin Core
Title
Does the time of the day affect multiple trauma care in hospitals? A retrospective analysis of data from the TraumaRegister DGU®
Subject
Multiple trauma, TraumaRegister DGU®, Day shift, Night shift, Admission
Description
Background: Optimal multiple trauma care should be continuously provided during the day and night. Several
studies have demonstrated worse outcomes and higher mortality in patients admitted at night. This study involved
the analysis of a population of multiple trauma patients admitted at night and a comparison of various indicators of
the quality of care at different admission times.
Methods: Data from 58,939 multiple trauma patients from 2007 to 2017 were analyzed retrospectively. All data
were obtained from TraumaRegister DGU®. Patients were grouped by the time of their admission to the trauma
center (6.00 am–11.59 am (morning), 12.00 pm–5.59 pm (afternoon), 6.00 pm–11.59 pm (evening), 0.00 am–5.59 am
(night)). Incidences, patient demographics, injury patterns, trauma center levels and trauma care times and
outcomes were evaluated.
Results: Fewer patients were admitted during the night (6.00 pm–11.59 pm: 18.8% of the patients, 0.00–5.59 am:
4.6% of the patients) than during the day. Patients who arrived between 0.00 am–5.59 am were younger (49.4 ±
22.8 years) and had a higher injury severity score (ISS) (21.4 ± 11.5) and lower Glasgow Coma Scale (GCS) score
(11.6 ± 4.4) than those admitted during the day (12.00 pm–05.59 pm; age: 55.3 ± 21.6 years, ISS: 20.6 ± 11.4, GCS:
12.6 ± 4.0). Time in the trauma department and time to an emergency operation were only marginally different.
Time to imaging was slightly prolonged during the night (0.00 am–5.59 am: X-ray 16.2 ± 19.8 min; CT scan 24.3 ±
18.1 min versus 12.00 pm- 5.59 pm: X-ray 15.4 ± 19.7 min; CT scan 22.5 ± 17.8 min), but the delay did not affect the
outcome. The outcome was also not affected by level of the trauma center. There was no relevant difference in the
Revised Injury Severity Classification II (RISC II) score or mortality rate between patients admitted during the day and
at night. There were no differences in RISC II scores or mortality rates according to time period. Admission at night
was not a predictor of a higher mortality rate.
Conclusion: The patient population and injury severity vary between the day and night with regard to age, injury
pattern and trauma mechanism. Despite the differences in these factors, arrival at night did not have a negative
effect on the outcome.
studies have demonstrated worse outcomes and higher mortality in patients admitted at night. This study involved
the analysis of a population of multiple trauma patients admitted at night and a comparison of various indicators of
the quality of care at different admission times.
Methods: Data from 58,939 multiple trauma patients from 2007 to 2017 were analyzed retrospectively. All data
were obtained from TraumaRegister DGU®. Patients were grouped by the time of their admission to the trauma
center (6.00 am–11.59 am (morning), 12.00 pm–5.59 pm (afternoon), 6.00 pm–11.59 pm (evening), 0.00 am–5.59 am
(night)). Incidences, patient demographics, injury patterns, trauma center levels and trauma care times and
outcomes were evaluated.
Results: Fewer patients were admitted during the night (6.00 pm–11.59 pm: 18.8% of the patients, 0.00–5.59 am:
4.6% of the patients) than during the day. Patients who arrived between 0.00 am–5.59 am were younger (49.4 ±
22.8 years) and had a higher injury severity score (ISS) (21.4 ± 11.5) and lower Glasgow Coma Scale (GCS) score
(11.6 ± 4.4) than those admitted during the day (12.00 pm–05.59 pm; age: 55.3 ± 21.6 years, ISS: 20.6 ± 11.4, GCS:
12.6 ± 4.0). Time in the trauma department and time to an emergency operation were only marginally different.
Time to imaging was slightly prolonged during the night (0.00 am–5.59 am: X-ray 16.2 ± 19.8 min; CT scan 24.3 ±
18.1 min versus 12.00 pm- 5.59 pm: X-ray 15.4 ± 19.7 min; CT scan 22.5 ± 17.8 min), but the delay did not affect the
outcome. The outcome was also not affected by level of the trauma center. There was no relevant difference in the
Revised Injury Severity Classification II (RISC II) score or mortality rate between patients admitted during the day and
at night. There were no differences in RISC II scores or mortality rates according to time period. Admission at night
was not a predictor of a higher mortality rate.
Conclusion: The patient population and injury severity vary between the day and night with regard to age, injury
pattern and trauma mechanism. Despite the differences in these factors, arrival at night did not have a negative
effect on the outcome.
Creator
Stefanie Fitschen-Oestern, Sebastian Lippross, Rolf Lefering, Tim Klüter, Matthias Weuster, Georg Maximilian Franke, Nora Kirsten, Michael Müller, Ove Schröder, Andreas Seekamp and TraumaRegister DGU
Publisher
BMC Emergency Medicine
Date
(2021) 21:134
Contributor
Fajar bagus W
Format
PDF
Language
English
Type
Text
Files
Collection
Citation
Stefanie Fitschen-Oestern, Sebastian Lippross, Rolf Lefering, Tim Klüter, Matthias Weuster, Georg Maximilian Franke, Nora Kirsten, Michael Müller, Ove Schröder, Andreas Seekamp and TraumaRegister DGU, “Does the time of the day affect multiple trauma care in hospitals? A retrospective analysis of data from the TraumaRegister DGU®,” Repository Horizon University Indonesia, accessed November 21, 2024, https://repository.horizon.ac.id/items/show/3900.