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Health care utilization outcomes in patients with blunt chest wall trauma following discharge from the emergency department: A retrospective, observational data-linkage study
Journal of Trauma and Acute Care Surgery, Volume: 95, Issue: 6, Pages: 868 - 874
Swansea University Authors:
Ceri Battle, Hayley Hutchings , Jim Rafferty
, Ashley Akbari
, Alan Watkins
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DOI (Published version): 10.1097/ta.0000000000004086
Abstract
Background : Whilst much is published reporting clinical outcomes in the patients with blunt chest wall trauma who are admitted to hospital from the ED, less is known about the patients’ recovery when they are discharged directly without admission. The aim of this study was to investigate the health...
Published in: | Journal of Trauma and Acute Care Surgery |
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ISSN: | 2163-0755 2163-0763 |
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Ovid Technologies (Wolters Kluwer Health)
2023
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URI: | https://cronfa.swan.ac.uk/Record/cronfa64513 |
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<?xml version="1.0" encoding="utf-8"?><rfc1807 xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:xsd="http://www.w3.org/2001/XMLSchema"><bib-version>v2</bib-version><id>64513</id><entry>2023-09-12</entry><title>Health care utilization outcomes in patients with blunt chest wall trauma following discharge from the emergency department: A retrospective, observational data-linkage study</title><swanseaauthors><author><sid>9ae21f1afb903db3c39684cd47b94760</sid><firstname>Ceri</firstname><surname>Battle</surname><name>Ceri Battle</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>bdf5d5f154d339dd92bb25884b7c3652</sid><ORCID>0000-0003-4155-1741</ORCID><firstname>Hayley</firstname><surname>Hutchings</surname><name>Hayley Hutchings</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>52effe759a718bd36eb12cdd10fe1a09</sid><ORCID>0000-0002-1667-7265</ORCID><firstname>Jim</firstname><surname>Rafferty</surname><name>Jim Rafferty</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>aa1b025ec0243f708bb5eb0a93d6fb52</sid><ORCID>0000-0003-0814-0801</ORCID><firstname>Ashley</firstname><surname>Akbari</surname><name>Ashley Akbari</name><active>true</active><ethesisStudent>false</ethesisStudent></author><author><sid>81fc05c9333d9df41b041157437bcc2f</sid><ORCID>0000-0003-3804-1943</ORCID><firstname>Alan</firstname><surname>Watkins</surname><name>Alan Watkins</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2023-09-12</date><abstract>Background : Whilst much is published reporting clinical outcomes in the patients with blunt chest wall trauma who are admitted to hospital from the ED, less is known about the patients’ recovery when they are discharged directly without admission. The aim of this study was to investigate the healthcare utilisation outcomes in adult patients with blunt chest wall trauma, discharged directly from ED in a trauma unit in the UK. Methods : This was a longitudinal, retrospective, single-centre, observational study incorporating analysis of linked datasets, using the Secure Anonymised Information Linkage (SAIL) databank for admissions to a trauma unit in the Wales, between 1st January 2016 and 31st December 2020. All patients aged ≥16 years with a primary diagnosis of blunt chest wall trauma discharged directly home were included. Data was analysed using a negative binomial regression model. Results : 3205 presentations to the ED were included. Mean age was 53 years, 57% were male, with the predominant injury mechanism being a low velocity fall (50%). 93% of the cohort sustained between 0-3 rib fractures. 4% of the cohort were reported to have COPD, and 4% using pre-injury anticoagulants. On regression analysis, inpatient admissions, outpatient appointments and primary care contacts all significantly increased in the 12-week period post-injury, compared with the 12-week period pre-injury (OR: 1.63 95% CI: 1.33-1.99, p < 0.001; OR: 1.28, 95% CI: 1.14-1.43, p < 0.001; OR: 1.02. 95% CI: 1.01-1.02, p < 0.001 respectively). Risk of healthcare resource utilisation increased significantly with each additional year of age, COPD and pre-injury anti-coagulant use (all p < 0.05). Social deprivation and number of rib fracture did not impact outcomes. Conclusion : The results of this study demonstrate the need for appropriate signposting and follow-up for patients with blunt chest wall trauma presenting to the ED, not requiring admission to the hospital.</abstract><type>Journal Article</type><journal>Journal of Trauma and Acute Care Surgery</journal><volume>95</volume><journalNumber>6</journalNumber><paginationStart>868</paginationStart><paginationEnd>874</paginationEnd><publisher>Ovid Technologies (Wolters Kluwer Health)</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>2163-0755</issnPrint><issnElectronic>2163-0763</issnElectronic><keywords>Rib fractures, Outcomes, Data linkage</keywords><publishedDay>1</publishedDay><publishedMonth>12</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-12-01</publishedDate><doi>10.1097/ta.0000000000004086</doi><url/><notes/><college>COLLEGE NANME</college><CollegeCode>COLLEGE CODE</CollegeCode><institution>Swansea University</institution><apcterm/><funders>This study was funded as part of a Health Research Fellowship Awarded to Ceri Battle by Health and Care Research Wales, on behalf of Welsh Government.</funders><projectreference/><lastEdited>2024-07-29T15:05:18.2939825</lastEdited><Created>2023-09-12T16:31:43.0430634</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">Swansea University Medical School - Medicine</level></path><authors><author><firstname>Ceri</firstname><surname>Battle</surname><order>1</order></author><author><firstname>Hayley</firstname><surname>Hutchings</surname><orcid>0000-0003-4155-1741</orcid><order>2</order></author><author><firstname>Jim</firstname><surname>Rafferty</surname><orcid>0000-0002-1667-7265</orcid><order>3</order></author><author><firstname>Hannah</firstname><surname>Toghill</surname><order>4</order></author><author><firstname>Ashley</firstname><surname>Akbari</surname><orcid>0000-0003-0814-0801</orcid><order>5</order></author><author><firstname>Alan</firstname><surname>Watkins</surname><orcid>0000-0003-3804-1943</orcid><order>6</order></author></authors><documents><document><filename>64513__28514__e39cab2de4074c1593bcb898089768c5.pdf</filename><originalFilename>Healthcare_utilisation_outcomes_in_patients_with.450.pdf</originalFilename><uploaded>2023-09-12T16:35:14.2959881</uploaded><type>Output</type><contentLength>2166659</contentLength><contentType>application/pdf</contentType><version>Accepted Manuscript</version><cronfaStatus>true</cronfaStatus><embargoDate>2024-05-30T00:00:00.0000000</embargoDate><copyrightCorrect>true</copyrightCorrect><language>eng</language></document></documents><OutputDurs/></rfc1807> |
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v2 64513 2023-09-12 Health care utilization outcomes in patients with blunt chest wall trauma following discharge from the emergency department: A retrospective, observational data-linkage study 9ae21f1afb903db3c39684cd47b94760 Ceri Battle Ceri Battle true false bdf5d5f154d339dd92bb25884b7c3652 0000-0003-4155-1741 Hayley Hutchings Hayley Hutchings true false 52effe759a718bd36eb12cdd10fe1a09 0000-0002-1667-7265 Jim Rafferty Jim Rafferty true false aa1b025ec0243f708bb5eb0a93d6fb52 0000-0003-0814-0801 Ashley Akbari Ashley Akbari true false 81fc05c9333d9df41b041157437bcc2f 0000-0003-3804-1943 Alan Watkins Alan Watkins true false 2023-09-12 Background : Whilst much is published reporting clinical outcomes in the patients with blunt chest wall trauma who are admitted to hospital from the ED, less is known about the patients’ recovery when they are discharged directly without admission. The aim of this study was to investigate the healthcare utilisation outcomes in adult patients with blunt chest wall trauma, discharged directly from ED in a trauma unit in the UK. Methods : This was a longitudinal, retrospective, single-centre, observational study incorporating analysis of linked datasets, using the Secure Anonymised Information Linkage (SAIL) databank for admissions to a trauma unit in the Wales, between 1st January 2016 and 31st December 2020. All patients aged ≥16 years with a primary diagnosis of blunt chest wall trauma discharged directly home were included. Data was analysed using a negative binomial regression model. Results : 3205 presentations to the ED were included. Mean age was 53 years, 57% were male, with the predominant injury mechanism being a low velocity fall (50%). 93% of the cohort sustained between 0-3 rib fractures. 4% of the cohort were reported to have COPD, and 4% using pre-injury anticoagulants. On regression analysis, inpatient admissions, outpatient appointments and primary care contacts all significantly increased in the 12-week period post-injury, compared with the 12-week period pre-injury (OR: 1.63 95% CI: 1.33-1.99, p < 0.001; OR: 1.28, 95% CI: 1.14-1.43, p < 0.001; OR: 1.02. 95% CI: 1.01-1.02, p < 0.001 respectively). Risk of healthcare resource utilisation increased significantly with each additional year of age, COPD and pre-injury anti-coagulant use (all p < 0.05). Social deprivation and number of rib fracture did not impact outcomes. Conclusion : The results of this study demonstrate the need for appropriate signposting and follow-up for patients with blunt chest wall trauma presenting to the ED, not requiring admission to the hospital. Journal Article Journal of Trauma and Acute Care Surgery 95 6 868 874 Ovid Technologies (Wolters Kluwer Health) 2163-0755 2163-0763 Rib fractures, Outcomes, Data linkage 1 12 2023 2023-12-01 10.1097/ta.0000000000004086 COLLEGE NANME COLLEGE CODE Swansea University This study was funded as part of a Health Research Fellowship Awarded to Ceri Battle by Health and Care Research Wales, on behalf of Welsh Government. 2024-07-29T15:05:18.2939825 2023-09-12T16:31:43.0430634 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Ceri Battle 1 Hayley Hutchings 0000-0003-4155-1741 2 Jim Rafferty 0000-0002-1667-7265 3 Hannah Toghill 4 Ashley Akbari 0000-0003-0814-0801 5 Alan Watkins 0000-0003-3804-1943 6 64513__28514__e39cab2de4074c1593bcb898089768c5.pdf Healthcare_utilisation_outcomes_in_patients_with.450.pdf 2023-09-12T16:35:14.2959881 Output 2166659 application/pdf Accepted Manuscript true 2024-05-30T00:00:00.0000000 true eng |
title |
Health care utilization outcomes in patients with blunt chest wall trauma following discharge from the emergency department: A retrospective, observational data-linkage study |
spellingShingle |
Health care utilization outcomes in patients with blunt chest wall trauma following discharge from the emergency department: A retrospective, observational data-linkage study Ceri Battle Hayley Hutchings Jim Rafferty Ashley Akbari Alan Watkins |
title_short |
Health care utilization outcomes in patients with blunt chest wall trauma following discharge from the emergency department: A retrospective, observational data-linkage study |
title_full |
Health care utilization outcomes in patients with blunt chest wall trauma following discharge from the emergency department: A retrospective, observational data-linkage study |
title_fullStr |
Health care utilization outcomes in patients with blunt chest wall trauma following discharge from the emergency department: A retrospective, observational data-linkage study |
title_full_unstemmed |
Health care utilization outcomes in patients with blunt chest wall trauma following discharge from the emergency department: A retrospective, observational data-linkage study |
title_sort |
Health care utilization outcomes in patients with blunt chest wall trauma following discharge from the emergency department: A retrospective, observational data-linkage study |
author_id_str_mv |
9ae21f1afb903db3c39684cd47b94760 bdf5d5f154d339dd92bb25884b7c3652 52effe759a718bd36eb12cdd10fe1a09 aa1b025ec0243f708bb5eb0a93d6fb52 81fc05c9333d9df41b041157437bcc2f |
author_id_fullname_str_mv |
9ae21f1afb903db3c39684cd47b94760_***_Ceri Battle bdf5d5f154d339dd92bb25884b7c3652_***_Hayley Hutchings 52effe759a718bd36eb12cdd10fe1a09_***_Jim Rafferty aa1b025ec0243f708bb5eb0a93d6fb52_***_Ashley Akbari 81fc05c9333d9df41b041157437bcc2f_***_Alan Watkins |
author |
Ceri Battle Hayley Hutchings Jim Rafferty Ashley Akbari Alan Watkins |
author2 |
Ceri Battle Hayley Hutchings Jim Rafferty Hannah Toghill Ashley Akbari Alan Watkins |
format |
Journal article |
container_title |
Journal of Trauma and Acute Care Surgery |
container_volume |
95 |
container_issue |
6 |
container_start_page |
868 |
publishDate |
2023 |
institution |
Swansea University |
issn |
2163-0755 2163-0763 |
doi_str_mv |
10.1097/ta.0000000000004086 |
publisher |
Ovid Technologies (Wolters Kluwer Health) |
college_str |
Faculty of Medicine, Health and Life Sciences |
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facultyofmedicinehealthandlifesciences |
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Faculty of Medicine, Health and Life Sciences |
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facultyofmedicinehealthandlifesciences |
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Faculty of Medicine, Health and Life Sciences |
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Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine |
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description |
Background : Whilst much is published reporting clinical outcomes in the patients with blunt chest wall trauma who are admitted to hospital from the ED, less is known about the patients’ recovery when they are discharged directly without admission. The aim of this study was to investigate the healthcare utilisation outcomes in adult patients with blunt chest wall trauma, discharged directly from ED in a trauma unit in the UK. Methods : This was a longitudinal, retrospective, single-centre, observational study incorporating analysis of linked datasets, using the Secure Anonymised Information Linkage (SAIL) databank for admissions to a trauma unit in the Wales, between 1st January 2016 and 31st December 2020. All patients aged ≥16 years with a primary diagnosis of blunt chest wall trauma discharged directly home were included. Data was analysed using a negative binomial regression model. Results : 3205 presentations to the ED were included. Mean age was 53 years, 57% were male, with the predominant injury mechanism being a low velocity fall (50%). 93% of the cohort sustained between 0-3 rib fractures. 4% of the cohort were reported to have COPD, and 4% using pre-injury anticoagulants. On regression analysis, inpatient admissions, outpatient appointments and primary care contacts all significantly increased in the 12-week period post-injury, compared with the 12-week period pre-injury (OR: 1.63 95% CI: 1.33-1.99, p < 0.001; OR: 1.28, 95% CI: 1.14-1.43, p < 0.001; OR: 1.02. 95% CI: 1.01-1.02, p < 0.001 respectively). Risk of healthcare resource utilisation increased significantly with each additional year of age, COPD and pre-injury anti-coagulant use (all p < 0.05). Social deprivation and number of rib fracture did not impact outcomes. Conclusion : The results of this study demonstrate the need for appropriate signposting and follow-up for patients with blunt chest wall trauma presenting to the ED, not requiring admission to the hospital. |
published_date |
2023-12-01T15:05:16Z |
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11.021648 |