Patient and process factors associated with opportunities for improvement in trauma care: a registry-based study
Abstract Background Trauma is one of the leading causes of morbidity and mortality worldwide. Morbidity and mortality review of selected patient cases is used to improve the quality of trauma care by identifying opportunities for improvement (OFI). The aim of this study was to assess how patient and...
| Main Authors: | , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-11-01
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| Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13049-023-01157-y |
| _version_ | 1797414168737873920 |
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| author | Hussein Albaaj Jonatan Attergrim Lovisa Strömmer Olof Brattström Martin Jacobsson Gunilla Wihlke Liselott Västerbo Elias Joneborg Martin Gerdin Wärnberg |
| author_facet | Hussein Albaaj Jonatan Attergrim Lovisa Strömmer Olof Brattström Martin Jacobsson Gunilla Wihlke Liselott Västerbo Elias Joneborg Martin Gerdin Wärnberg |
| author_sort | Hussein Albaaj |
| collection | DOAJ |
| description | Abstract Background Trauma is one of the leading causes of morbidity and mortality worldwide. Morbidity and mortality review of selected patient cases is used to improve the quality of trauma care by identifying opportunities for improvement (OFI). The aim of this study was to assess how patient and process factors are associated with OFI in trauma care. Methods We conducted a registry-based study using all patients between 2017 and 2021 from the Karolinska University Hospital who had been reviewed regarding the presence of OFI as defined by a morbidity and mortality conference. We used bi- and multivariable logistic regression to assess the associations between the following patient and process factors and OFI: age, sex, respiratory rate, systolic blood pressure, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), survival at 30 days, highest hospital care level, arrival on working hours, arrival on weekends, intubation status and time to first computed tomography (CT). Results OFI was identified in 300 (5.8%) out of 5182 patients. Age, missing Glasgow Coma Scale, time to first CT, highest hospital care level and ISS were statistically significantly associated with OFI. Conclusion Several patient and process factors were found to be associated with OFI, indicating that patients with moderate to severe trauma and those with delays to first CT are at the highest odds of OFI. |
| first_indexed | 2024-03-09T05:29:10Z |
| format | Article |
| id | doaj.art-4252f165911447e28f512d0229aa13f6 |
| institution | Directory Open Access Journal |
| issn | 1757-7241 |
| language | English |
| last_indexed | 2024-03-09T05:29:10Z |
| publishDate | 2023-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| spelling | doaj.art-4252f165911447e28f512d0229aa13f62023-12-03T12:34:14ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412023-11-013111810.1186/s13049-023-01157-yPatient and process factors associated with opportunities for improvement in trauma care: a registry-based studyHussein Albaaj0Jonatan Attergrim1Lovisa Strömmer2Olof Brattström3Martin Jacobsson4Gunilla Wihlke5Liselott Västerbo6Elias Joneborg7Martin Gerdin Wärnberg8Department of Global Public Health, Karolinska InstitutetDepartment of Global Public Health, Karolinska InstitutetDivision of Surgery, Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska InstitutetPerioperative Medicine and Intensive Care, Karolinska University HospitalDepartment of Biomedical Engineering and Health Systems, KTH Royal Institute of TechnologyTrauma and Reparative Medicine, Karolinska University HospitalTrauma and Reparative Medicine, Karolinska University HospitalDepartment of Global Public Health, Karolinska InstitutetDepartment of Global Public Health, Karolinska InstitutetAbstract Background Trauma is one of the leading causes of morbidity and mortality worldwide. Morbidity and mortality review of selected patient cases is used to improve the quality of trauma care by identifying opportunities for improvement (OFI). The aim of this study was to assess how patient and process factors are associated with OFI in trauma care. Methods We conducted a registry-based study using all patients between 2017 and 2021 from the Karolinska University Hospital who had been reviewed regarding the presence of OFI as defined by a morbidity and mortality conference. We used bi- and multivariable logistic regression to assess the associations between the following patient and process factors and OFI: age, sex, respiratory rate, systolic blood pressure, Glasgow Coma Scale (GCS), Injury Severity Score (ISS), survival at 30 days, highest hospital care level, arrival on working hours, arrival on weekends, intubation status and time to first computed tomography (CT). Results OFI was identified in 300 (5.8%) out of 5182 patients. Age, missing Glasgow Coma Scale, time to first CT, highest hospital care level and ISS were statistically significantly associated with OFI. Conclusion Several patient and process factors were found to be associated with OFI, indicating that patients with moderate to severe trauma and those with delays to first CT are at the highest odds of OFI.https://doi.org/10.1186/s13049-023-01157-yTraumaOpportunities for improvementTrauma careAcute surgery |
| spellingShingle | Hussein Albaaj Jonatan Attergrim Lovisa Strömmer Olof Brattström Martin Jacobsson Gunilla Wihlke Liselott Västerbo Elias Joneborg Martin Gerdin Wärnberg Patient and process factors associated with opportunities for improvement in trauma care: a registry-based study Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Trauma Opportunities for improvement Trauma care Acute surgery |
| title | Patient and process factors associated with opportunities for improvement in trauma care: a registry-based study |
| title_full | Patient and process factors associated with opportunities for improvement in trauma care: a registry-based study |
| title_fullStr | Patient and process factors associated with opportunities for improvement in trauma care: a registry-based study |
| title_full_unstemmed | Patient and process factors associated with opportunities for improvement in trauma care: a registry-based study |
| title_short | Patient and process factors associated with opportunities for improvement in trauma care: a registry-based study |
| title_sort | patient and process factors associated with opportunities for improvement in trauma care a registry based study |
| topic | Trauma Opportunities for improvement Trauma care Acute surgery |
| url | https://doi.org/10.1186/s13049-023-01157-y |
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