Regional variation in hospital mortality and 30-day mortality for injured Medicare patients.
World J Surg
; 32(6): 954-9, 2008 Jun.
Article
em En
| MEDLINE
| ID: mdl-18224464
ABSTRACT
BACKGROUND:
We sought to evaluate how survival of older patients with injuries differs by geographic region within the United States.METHODS:
We analyzed Medicare fee-for-service records for patients aged 65 years and older with principal injury diagnoses (ICD-9 800-959, excluding 905, 930-939, 958). Cases were classified by Maximum Abbreviated Injury Score (AISmax) and Charlson Comorbidity score (0, 1, 2, >or=3). Hospital mortality and 30-day mortality were modeled as functions of age, sex, AISmax, comorbidity, and geographic region (northeast, midwest, south, west).RESULTS:
Hospital and 30-day mortality were both higher with male sex and increased age, AISmax, or Charlson score. Adjusted hospital mortality was highest in the northeast and south, but 30-day adjusted mortality was lowest in the same two regions.CONCLUSIONS:
Regional differences in risk-adjusted hospital survival for older patients with injuries are different from regional differences in 30-day survival. Hospital mortality as an outcome for older injured patients should be interpreted cautiously.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Ferimentos e Lesões
/
Medicare
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2008
Tipo de documento:
Article