Temporal variation in major trauma admissions

Kieffer, Will; Michalik, D.; Gallagher, Kieran; McFadyen, I.; Bernard, J; Rogers, Benedict A.

doi:10.1308/rcsann.2016.0040

Cited by 19 publications

(21 citation statements)

References 26 publications

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“…Studies on trauma populations describe trends towards increased admissions associated with warmer weather and summer months (northern temperate zone) (Kieffer et al 2016 ; Ali and Willett 2015 ; Rising et al 2006 ; Roislien et al 2018 ; Bjarkø et al 2019 ). However, our study did not identify significant variations between monthly admissions or TBI severity during the five-year period.…”

Section: Discussionmentioning

confidence: 99%

“…Hence, for in hospital resource planning accurate information on patient load, patient characteristics, injury severity and time of admittance is of great importance. Several studies have shown the number of admissions for trauma patients increases on weekends, in the evenings, and are subject to seasonal variation (Kieffer et al 2016 ; Robertson and Giannoudis 2004 ; Stonko et al 2018 ; Vaziri et al 2007 ; Ali and Willett 2015 ; Rising et al 2006 ; Roislien et al 2018 ). We wanted to study the extent this is applicable to TBI patients.…”

Section: Introductionmentioning

confidence: 99%

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Characteristics of traumatic brain injury patients with abnormal neuroimaging in Southeast Norway

et al. 2020

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Background: The vast majority of hospital admitted patients with traumatic brain injury (TBI) will have intracranial injury identified by neuroimaging, requiring qualified staff and hospital beds. Moreover, increased pressure in health care services is expected because of an aging population. Thus, a regular evaluation of characteristics of hospital admitted patients with TBI is needed. Oslo TBI Registry-Neurosurgery prospectively register all patients with TBI identified by neuroimaging admitted to a trauma center for southeast part of Norway. The purpose of this study is to describe this patient population with respect to case load, time of admission, age, comorbidity, injury mechanism, injury characteristics, length of stay, and 30-days survival. Methods: Data for 5 years was extracted from Oslo TBI Registry-Neurosurgery. Case load, time of admission, age, sex, comorbidity, injury mechanism, injury characteristics, length of stay, and 30-days survival was compiled and compared. Results: From January 1st, 2015 to December 31st, 2019, 2153 consecutive patients with TBI identified by neuroimaging were registered. The admission rate of TBI of all severities has been stable year-round since 2015. Mean age was 52 years (standard deviation 25, range 0-99), and 68% were males. Comorbidities were common; 28% with pre-injury ASA score of ≥3 and 25% used antithrombotic medication. The dominating cause of injury in all ages was falls (55%) but increased with age. Upon admission, the head injury was classified as mild TBI in 46%, moderate in 28%, and severe (Glasgow coma score ≤ 8) in 26%. Case load was stable without seasonal variation. Majority of patients (68%) were admitted during evening, night or weekend. 68% was admitted to intensive care unit. Length of hospital stay was 4 days (median, interquartile range 3-9). 30-day survival for mild, moderate and severe TBI was 98, 94 and 69%, respectively. Conclusions: The typical TBI patients admitted to hospital with abnormal neuroimaging were aged 50-79 years, often with significant comorbidity, and admitted outside ordinary working hours. This suggests the necessity for allhour presence of competent health care professionals.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Characteristics of traumatic brain injury patients with abnormal neuroimaging in Southeast Norway

et al. 2020

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“…Studies exploring seasonal effects tend to treat months and years as separate units in time [ 3 , 7 , 8 , 27 ]. The observed long-term non-linear increase in daily number of trauma admissions in this study underpins that using months as the unit of analysis cannot automatically be recommended, as this will effectively imply turning continuous time into a categorical variable, potentially masking clinically valuable information.…”

Section: Discussionmentioning

confidence: 99%

Seasonality in trauma admissions – Are daylight and weather variables better predictors than general cyclic effects?

2018

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BackgroundTrauma is a leading global cause of death, and predicting the burden of trauma admissions is vital for good planning of trauma care. Seasonality in trauma admissions has been found in several studies. Seasonal fluctuations in daylight hours, temperature and weather affect social and cultural practices but also individual neuroendocrine rhythms that may ultimately modify behaviour and potentially predispose to trauma. The aim of the present study was to explore to what extent the observed seasonality in daily trauma admissions could be explained by changes in daylight and weather variables throughout the year.MethodsRetrospective registry study on trauma admissions in the 10-year period 2001–2010 at Oslo University Hospital, Ullevål, Norway, where the amount of daylight varies from less than 6 hours to almost 19 hours per day throughout the year. Daily number of admissions was analysed by fitting non-linear Poisson time series regression models, simultaneously adjusting for several layers of temporal patterns, including a non-linear long-term trend and both seasonal and weekly cyclic effects. Five daylight and weather variables were explored, including hours of daylight and amount of precipitation. Models were compared using Akaike’s Information Criterion (AIC).ResultsA regression model including daylight and weather variables significantly outperformed a traditional seasonality model in terms of AIC. A cyclic week effect was significant in all models.ConclusionDaylight and weather variables are better predictors of seasonality in daily trauma admissions than mere information on day-of-year.

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“…Much like all medical and surgical specialties, there has been an anecdotal drop number of trauma calls per day, and the number of in‐patient admissions to our major trauma centre, one of the busiest in the United Kingdom. Previously, published literature from the UK has demonstrated significant seasonal variation in trauma admissions 6 . However, the impact of the pandemic, coupled with social isolation, on trauma admissions and the delivery of trauma care is not known.…”

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confidence: 99%