Hit by a Train: Injury Burden and Clinical Outcomes.
J Emerg Med
; 57(1): 6-12, 2019 Jul.
Article
em En
| MEDLINE
| ID: mdl-31078347
ABSTRACT
BACKGROUND:
Few data exist regarding the train vs. pedestrian (TVP) injury burden and outcomes.OBJECTIVE:
This study aimed to examine the epidemiology and outcomes associated with TVP injuries.METHODS:
This is a retrospective National Trauma Databank study (January 2007 to July 2012) including trauma patients sustaining TVP injury. Demographics, injury data, interventions, and outcomes were abstracted. Patients injured by a train were compared to patients who sustained an automobile vs. pedestrian (AVP) injury.RESULTS:
Of the 152,631 patients struck by ground transportation during the study time frame, 1863 (1.2%) were TVP. Median TVP age was 38 years (interquartile range [IQR] 24-50 years), 81.6% were male, median Injury Severity Score (ISS) was 13 (IQR 6-24). TVP patients were more severely injured (ISS 13 vs. 9; p < 0.001) and required more proximal amputations (13.4% vs. 0.2%; p < 0.001) and cavitary operations (18.2% vs. 2.8%; p < 0.001). TVP patients had higher rates of intensive care unit admission, mechanical ventilation and transfusion, longer length of stay, and higher in-hospital mortality. On multivariable logistical regression, TVP was an independent predictor for higher injury burden, ISS ≥25 (adjusted odds ratio [AOR] 1.650), immediate operative need (AOR 7.535), and complications (AOR 1.317).CONCLUSIONS:
TVP is associated with a significant injury burden. These patients have a significantly higher need for immediate operation and more complicated hospital course.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Ferimentos e Lesões
/
Acidentes de Trânsito
/
Efeitos Psicossociais da Doença
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article