Assuntos
Ciclismo/lesões , Traumatismos Craniocerebrais/prevenção & controle , Dispositivos de Proteção da Cabeça/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Traumatismos Craniocerebrais/etiologia , Feminino , Humanos , Masculino , Análise Multivariada , Características de Residência , Estudos Retrospectivos , Estados UnidosRESUMO
BACKGROUND: Surgical length of stay (LOS) has been correlated with quality of care, with shorter stays implying better care. The relationship between LOS and postdischarge complications (PDCs) has not been evaluated effectively. METHODS: The 2005 to 2007 National Surgical Quality Improvement Program data were queried for patients undergoing elective colectomies. The outcome of interest was the development of a PDC. Multivariate analysis was then performed adjusting for demographics, surgical approach, and comorbidities. RESULTS: A total of 12,956 colectomies were analyzed with an overall PDC of 8.7%. LOS was not associated with increased odds of developing a PDC. The laparoscopic approach reduced the risk of PDCs by 30% (odds ratio = .70, 95% confidence interval, 0.61-0.81). Body mass index, female sex, the presence of diabetes mellitus, and prolonged operative time increased the odds of developing a PDC. CONCLUSIONS: A shorter LOS did not correlate with a reduction in the likelihood of PDCs. Further investigation into the role of LOS as a measure of quality care is needed.
Assuntos
Colectomia , Tempo de Internação , Alta do Paciente , Complicações Pós-Operatórias/epidemiologia , Adulto , Índice de Massa Corporal , Diabetes Mellitus/epidemiologia , Procedimentos Cirúrgicos Eletivos , Feminino , Humanos , Laparoscopia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Duração da Cirurgia , Fatores Sexuais , Estados Unidos/epidemiologia , Adulto JovemRESUMO
The home remains a very common location for deadly injuries among children younger than 5 years. The aim of this study is to describe the demographic and injury characteristics of domestic injuries in children younger than 5 years. The National Trauma Data Bank's National Sample Program data set was queried for children younger than 5 years with the injury site classified as home. Bivariate analysis was performed to determine unadjusted differences by ethnicity. Appropriate weight was applied to the sample to determine accurate national estimates. A total of 7,364 children, representing 32,033 children, were analyzed. Overall mortality was 1.6 per cent. Among whites, blacks, Hispanics, Asians, and Native Americans, intentional injuries accounted for 6.5, 12.8, 10.2, 5.2, and 19.0 per cent of all injuries by intent, respectively (P < 0.003). Burn injury was disproportionately higher in blacks (24.1%) followed by Native Americans and Asians (15.3 and 11.5%, P = 0.008). On multivariate analysis, black ethnicity was associated with increased length of stay. Intentional injuries were significantly higher in blacks and Native Americans with black patients sustaining a disproportionately higher proportion of burn injury. Therefore, greater attention is needed to provide more effective home safety interventions to children among high-risk ethnic groups.
