Mortality in trauma patients admitted during, before, and after national academic emergency medicine and trauma surgery meeting dates in Japan

Abstract

13 14 15 16 2 17 Abstract18 Annually, many physicians attend national academic meetings. While participating in these meetings 19 can have a positive impact on daily medical practice, attendance may result in reduced medical 20 staffing during the meeting dates. We sought to examine whether there were differences in mortality 21 after trauma among patients admitted to the hospital during, before, and after meeting dates. Using 22 the Japan Trauma Data Bank, we analyzed in-hospital mortality in patients with traumatic injury 23 admitted to the hospital from 2004 to 2015 during the dates of two national academic meetings -the 24 Japanese Association for Acute Medicine (JAAM) and the Japanese Association for the Surgery of 25 Trauma (JAST). We compared the data with that of patients admitted with trauma during identical 26 weekdays in the weeks before and after the meetings, respectively. We used multiple logistic 27 regression analysis to compare outcomes among the three groups. A total of 7,491 patients were 28 included in our analyses, with 2,481, 2,492, and 2,518 patients in the during, before, and after 29 meeting dates groups, respectively; their mortality rates were 7.3%, 8.0%, and 8.5%, respectively.30 After adjusting for covariates, no significant differences in in-hospital mortality were found among 31 the three groups (adjusted odds ratio [95% CI] of the before meeting dates and after meeting dates 32 groups; 1.18 [0.89-1.56] and 1.23 [0.93-1.63], respectively, with the during meeting dates group as 3 33 the reference category). No significant differences in in-hospital mortality were found among trauma 34 patients admitted during, before, and after the JAAM and JAST meeting dates. 36 Introduction37 Appropriate medical staffing is essential to provide optimal trauma care [1]. Weekend or off-hours 38 admission has been shown to be associated with worse outcomes in patients with acute myocardial 39 infarction (AMI), stroke, pulmonary embolism, or those who required emergency general surgery 40 and were admitted to the intensive care unit [2][3][4][5][6]. This so-called "weekend effect" could possibly be 41 explained by reduced medical staffing and resources [7, 8]. 4243 This "national meeting effect" has been examined in recent years [9][10][11][12]. Each year, many 44 physicians attend national academic meetings and conferences to present their work, gain new 45 knowledge, and network. Although hospitals aim to consistently deliver high quality patient care 46 through efficient allocation of staff physicians, medical staffing during national meetings dates may 47 be lower than that during non-meeting dates. The "national meeting effect" in Japan has been 48 investigated; no significant differences were observed in outcomes among patients hospitalized with 4 49 AMI or cardiac arrest between meeting dates and non-meeting dates [9, 10]. Interestingly, lower 30-50 day mortality was found among high-risk patients with AMI, cardiac arrest, and heart failure in 51 teaching hospitals in the United States during na...

Top Major Traumas in Benghazi

“…Although no incidents were recorded from high altitudes, as most of cases were from heights less than 10 meters, which we believe is a matter of the availability and adherence to safety measures at work and in or outdoor, the lack of training programs for fall prevention and work experience especially among construction workers. However, the mortality rate during or after treatment (1.2%) of the total significant trauma in line with the average reports of (1.18-3.7%) in-hospital mortality in other regions indicates an acceptable level of management in this hospital [24][25][26]. 2.…”