The relationship between socioeconomic status and trauma outcomes

Abedzadeh-Kalahroudi, Masoumeh; Razi, Ebrahim; Sehat, Mojtaba

doi:10.1093/pubmed/fdy033

Cited by 17 publications

(8 citation statements)

References 42 publications

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“…Because this model controlled for confounding and included comorbidity data, we were able to analyze the potential effects of tracheostomy timing and technique while controlling for patient social factors, which have been shown to play an important role in patient outcomes. [28][29][30] In this study, having followed patients over a period of maximum 3 years following discharge, it is important to note that on observation of the Kaplan-Meier curves we see the majority of mortalities concentrated within the first 2 months. Thus, management efforts and followup planning should be targeted toward the immediate postdischarge period, regardless of patient demographic and tracheostomy timing and technique.…”

Section: Discussionmentioning

confidence: 88%

Effect of Patient Demographics and Tracheostomy Timing and Technique on Patient Survival

et al. 2020

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Objectives: The ideal timing and technique of tracheostomy vary among patients and may impact outcomes. We aim to examine the association between tracheostomy timing, placement technique, and patient demographics on survival.Study Design: Retrospective cohort study. Methods: A retrospective review was performed for all patients who underwent tracheostomy in 2016 and 2017 at one urban academic tertiary-care hospital. Kaplan-Meier curves were created based on combinations of tracheostomy timing and technique (early percutaneous, early non-percutaneous, late percutaneous, and late non-percutaneous). Cox proportional hazard models were used to determine multivariable effects of timing, technique, and other demographic factors. Primary outcome measures were tracheostomy-related mortality and overall survival. Secondary outcomes were in-hospital, 30-day, and 90-day mortality.Results: Our study included 523 patients. There were six tracheostomy-related deaths, with hemorrhage and tracheoesophageal fistula being the most common causes. Tracheostomy timing and technique combinations were not associated with differences in all-cause mortality or survival following discharge. Cox proportional hazard models showed that Charlson Comorbidity Index (CCI) and unknown partner status were associated with a decrease in survival (P < .01 and P = .05, respectively). Additionally, patient age, gender, race, CCI, and body mass index were not independently associated with changes in survival.Conclusion: Late and non-percutaneous tracheostomies were associated with more tracheostomy-related deaths, but timing and technique were not associated with differences in patient survival. Multiple regression analysis showed that increased patient comorbidities, measured via CCI, and unknown partner status were independently associated with decreased survival. Proceduralists should discuss timing, technique, and patient social factors together with the medical care team when constructing plans for postdischarge management.

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Section: Discussionmentioning

confidence: 88%

Effect of Patient Demographics and Tracheostomy Timing and Technique on Patient Survival

et al. 2020

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“…(-Sheppard et al, 2008;Pridemore & Grubesic, 2013;Britt et al, 2005;Cameron et al, 2016;Cunradi et al, 2011;Cunradi et al, 2012;Gorman et al, 1998;Gorman et al, 2005;Grubesic & Pridemore, 2011;Lipton & Gruenewald, 2002;Livingston, 2011;Reid et al, 2003;Resko et al, 2010;Scribner et al, 1995;Zhu et al, 2004) Similarly, neighborhood social disadvantage or socioeconomic status (SES) has been associated with interpersonal violence and injury. (Bouffard & Muftić, 2006;Boyle & Hassett-Walker, 2008;Valdez et al, 2007;Simpson et al, 2005;Abedzadeh-Kalahroudi et al, 2018;Chong et al, 2015;Halonen et al, 2012;Jarman et al, 2018a;Lawson et al, 2015;Markowitz, 2003;Zarzur et al, 2010) Numerous metrics of areal SES have been evaluated by previous investigators for association with traumatic injury and survival. (Bouffard & Muftić, 2006;Boyle & Hassett-Walker, 2008;Valdez et al, 2007;Simpson et al, 2005;Abedzadeh-Kalahroudi et al, 2018;Chong et al, 2015;Halonen et al, 2012;Jarman et al, 2018a;Lawson et al, 2015;Bell et al, 2015;Cubbin et al, 2000a;…”

Section: Introductionmentioning

confidence: 99%

“…(Bouffard & Muftić, 2006;Boyle & Hassett-Walker, 2008;Valdez et al, 2007;Simpson et al, 2005;Abedzadeh-Kalahroudi et al, 2018;Chong et al, 2015;Halonen et al, 2012;Jarman et al, 2018a;Lawson et al, 2015;Markowitz, 2003;Zarzur et al, 2010) Numerous metrics of areal SES have been evaluated by previous investigators for association with traumatic injury and survival. (Bouffard & Muftić, 2006;Boyle & Hassett-Walker, 2008;Valdez et al, 2007;Simpson et al, 2005;Abedzadeh-Kalahroudi et al, 2018;Chong et al, 2015;Halonen et al, 2012;Jarman et al, 2018a;Lawson et al, 2015;Bell et al, 2015;Cubbin et al, 2000a;Cubbin & Smith, 2002;Jarman et al, 2018b) However, no consensus regarding the best features to model SES has been established. (Kruithof et al, 2017) It is unlikely that alcohol availability and SES promote injury-causing events uniformly across geographic regions and populations.…”

Section: Introductionmentioning

confidence: 99%

Geospatial characteristics of non-motor vehicle and assault-related trauma events in greater Phoenix, Arizona

et al. 2020

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Background: Injury-causing events are not randomly distributed across a landscape, but how they are associated with the features and characteristics of the places where they occur in Arizona (AZ) remains understudied. Clustering of trauma events and associations with areal sociodemographic characteristics in the greater Phoenix (PHX), AZ region can promote understanding and inform efforts to ameliorate a leading cause of death and disability for Arizonans. The outcomes of interest are trauma events unrelated to motor vehicle crashes (MVC) and the subgroup of trauma events due to interpersonal assaults. Methods: A retrospective, ecological study was performed incorporating data from state and national sources for the years 2013-2017. Geographically weighted regression models explored associations between the rates of non-MVC trauma events (n/10,000 population) and the subgroup of assaultive trauma events per 1000 and areal characteristics of socioeconomic deprivation (areal deprivation index [ADI]), the density of retail alcohol outlets for offsite consumption, while controlling for race/ethnicity, population density, and the percentage urban population. Results: The 63,451 non-MVC traumas within a 3761 mile 2 study area encompassing PHX and 22 surrounding communities, an area with nearly 60% of the state's population and 54% of the trauma events in the AZ State Trauma Registry for the years 2013-2017. Adjusting for confounders, ADI was associated with the rates of non-MVC and assaultive traumas in all census block groups studied (mean coefficients 0.05 sd. 0.001 and 0.07 sd. 0.002 for non-MVC and assaultive trauma, respectively). Alcohol retail outlet density was also associated with non-MVC and assaultive traumas in fewer block groups compared to ADI. Conclusion: Socioeconomic deprivation and alcohol outlet density were associated with injury producing events in the greater PHX area. These features persist in the environment before and after the traumas occur. Ongoing research is warranted to identify the most influential areal predictors of traumatic injury-causing events in the greater PHX area to inform and geographically target prevention initiatives.

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“…Estrategias para promover estilos de vida saludable son necesarias para hacer que este fenómeno demográfico sea más sustentable 1 . La evaluación de diferentes niveles de limitaciones funcionales es fundamental para entender mejor las diferencias entre las necesidades y demandas de los adultos mayores, pues los niveles de dependencia están asociados a una mayor demanda por cuidados a largo plazo y mortalidad 5 . Por otro lado, estudios sugieren que el análisis de diferentes regiones, aspectos socioeconómicos y demográficos son de gran importancia para la planificación y el delineamiento de políticas públicas orientadas al bienestar de la población adulta mayor 6,7 .…”

Section: Introductionunclassified

Actividad física, salud y funcionalidad entre adultos mayores según la localidad geográfica

Oliveira

Sepúlveda-Loyola

Freire

et al. 2019

Rev Bras Ativ Fís Saúde

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Este estudio transversal comparó las diferencias sociodemográficas, auto percepción de salud, nivel de actividad física y la funcionalidad de los adultos mayores adscritos a centros de atención pública de diferentes sectores geográficos de una ciudad brasileira. Estudio epidemiológico con 654 adultos mayores (69,42 ± 7,51 años), de ambos los sexos, de la comuna de Maringá, Brasil. Los sujetos fueron reclutados de cuatro diferentes regiones. Fue evaluado el perfil sociodemográfico, nivel educacional, auto percepción de salud, nivel de actividad física y la funcionalidad. Los ancianos entre 60 - 69 y 70 - 79 años tenían tres veces más probabilidades de vivir en las regiones sur y oeste. Las personas mayores con educación superior tienen más probabilidades de vivir en el este y oeste. Las personas mayores con mala percepción de salud y que informaron tomar más de dos medicamentos tenían más del 50,0% de probabilidades de vivir en la región oriental. La prevalencia del uso de más de dos medicamentos es mayor en el sector oeste (51,0%) y sur (52,0%). Los adultos mayores del sector norte realizan menos tiempo de actividad física moreda y vigorosa (p = 0.001), y los adultos mayores de la región sur presentan menor tiempo sentado (p = 0.001). Los adultos mayores de la región norte presentaban mejor funcionalidad (p = 0.001). Existen diferencias entre los factores sociodemográficos, condición de salud, nivel de actividad física, funcionalidad y participación social entre los adultos mayores que viven en diferentes barrios de una comuna que deben ser consideradas al momento de crear estrategias de salud pública.

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The relationship between socioeconomic status and trauma outcomes

Abstract: Patients with low SES are at greater risk for receiving low level of hospital care and experiencing non-RTW and needs to stronger post-discharge social supports.

Cited by 17 publications

References 42 publications

Effect of Patient Demographics and Tracheostomy Timing and Technique on Patient Survival

Effect of Patient Demographics and Tracheostomy Timing and Technique on Patient Survival

Geospatial characteristics of non-motor vehicle and assault-related trauma events in greater Phoenix, Arizona

Actividad física, salud y funcionalidad entre adultos mayores según la localidad geográfica

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