Correlation between Hospital Volume of Severely Injured Patients and In-Hospital Mortality of Severely Injured Pediatric Patients in Japan: A Nationwide 5-Year Retrospective Study
Appropriate trauma care systems, suitable for children are needed; thus, this retrospective nationwide study evaluated the correlation between the annual total hospital volume of severely injured patients and in-hospital mortality of severely injured pediatric patients (SIPP) and compared clinical p...
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| Format: | Article |
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MDPI AG
2021-04-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/7/1422 |
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| author | Chiaki Toida Takashi Muguruma Masayasu Gakumazawa Mafumi Shinohara Takeru Abe Ichiro Takeuchi Naoto Morimura |
| author_facet | Chiaki Toida Takashi Muguruma Masayasu Gakumazawa Mafumi Shinohara Takeru Abe Ichiro Takeuchi Naoto Morimura |
| author_sort | Chiaki Toida |
| collection | DOAJ |
| description | Appropriate trauma care systems, suitable for children are needed; thus, this retrospective nationwide study evaluated the correlation between the annual total hospital volume of severely injured patients and in-hospital mortality of severely injured pediatric patients (SIPP) and compared clinical parameters and outcomes per hospital between low- and high-volume hospitals. During the five-year study period, we enrolled 53,088 severely injured patients (Injury Severity Score, ≥16); 2889 (5.4%) were pediatric patients aged <18 years. Significant Spearman correlation analysis was observed between numbers of total patients and SIPP per hospital (<i>p</i> < 0.001), and the number of SIPP per hospital who underwent interhospital transportation and/or urgent treatment was correlated with the total number of severely injured patients per hospital. Actual in-hospital mortality, per hospital, of SIPP patients was significantly correlated with the total number patients per hospital (<i>p</i> < 0.001,). The total number of SIPP, requiring urgent treatment, was higher in the high-volume than in the low-volume hospital group. No significant differences in actual in-hospital morality (<i>p</i> = 0.246, 2.13 (0–8.33) vs. 0 (0–100)) and standardized mortality ratio (SMR) values (<i>p</i> = 0.244, 0.31 (0–0.79) vs. 0 (0–4.87)) were observed between the two groups; however, the 13 high-volume hospitals had an SMR of <1.0. Centralizing severely injured patients, regardless of age, to a higher volume hospital might contribute to survival benefits of SIPP. |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T12:43:01Z |
| publishDate | 2021-04-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-e66fecacf0c4466c8c622a9c1241fc292023-11-21T13:47:26ZengMDPI AGJournal of Clinical Medicine2077-03832021-04-01107142210.3390/jcm10071422Correlation between Hospital Volume of Severely Injured Patients and In-Hospital Mortality of Severely Injured Pediatric Patients in Japan: A Nationwide 5-Year Retrospective StudyChiaki Toida0Takashi Muguruma1Masayasu Gakumazawa2Mafumi Shinohara3Takeru Abe4Ichiro Takeuchi5Naoto Morimura6Department of Disaster Medical Management, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, JapanDepartment of Emergency Medicine, Graduate School of Medicine, Yokohama City University, 4-57 Urafunecho, Minami-ku, Yokohama 232-0024, JapanDepartment of Emergency Medicine, Graduate School of Medicine, Yokohama City University, 4-57 Urafunecho, Minami-ku, Yokohama 232-0024, JapanDepartment of Emergency Medicine, Graduate School of Medicine, Yokohama City University, 4-57 Urafunecho, Minami-ku, Yokohama 232-0024, JapanDepartment of Emergency Medicine, Graduate School of Medicine, Yokohama City University, 4-57 Urafunecho, Minami-ku, Yokohama 232-0024, JapanDepartment of Emergency Medicine, Graduate School of Medicine, Yokohama City University, 4-57 Urafunecho, Minami-ku, Yokohama 232-0024, JapanDepartment of Disaster Medical Management, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, JapanAppropriate trauma care systems, suitable for children are needed; thus, this retrospective nationwide study evaluated the correlation between the annual total hospital volume of severely injured patients and in-hospital mortality of severely injured pediatric patients (SIPP) and compared clinical parameters and outcomes per hospital between low- and high-volume hospitals. During the five-year study period, we enrolled 53,088 severely injured patients (Injury Severity Score, ≥16); 2889 (5.4%) were pediatric patients aged <18 years. Significant Spearman correlation analysis was observed between numbers of total patients and SIPP per hospital (<i>p</i> < 0.001), and the number of SIPP per hospital who underwent interhospital transportation and/or urgent treatment was correlated with the total number of severely injured patients per hospital. Actual in-hospital mortality, per hospital, of SIPP patients was significantly correlated with the total number patients per hospital (<i>p</i> < 0.001,). The total number of SIPP, requiring urgent treatment, was higher in the high-volume than in the low-volume hospital group. No significant differences in actual in-hospital morality (<i>p</i> = 0.246, 2.13 (0–8.33) vs. 0 (0–100)) and standardized mortality ratio (SMR) values (<i>p</i> = 0.244, 0.31 (0–0.79) vs. 0 (0–4.87)) were observed between the two groups; however, the 13 high-volume hospitals had an SMR of <1.0. Centralizing severely injured patients, regardless of age, to a higher volume hospital might contribute to survival benefits of SIPP.https://www.mdpi.com/2077-0383/10/7/1422pediatric patientseverely injured patientvolume–outcome relationshiphospital volumecentralization |
| spellingShingle | Chiaki Toida Takashi Muguruma Masayasu Gakumazawa Mafumi Shinohara Takeru Abe Ichiro Takeuchi Naoto Morimura Correlation between Hospital Volume of Severely Injured Patients and In-Hospital Mortality of Severely Injured Pediatric Patients in Japan: A Nationwide 5-Year Retrospective Study Journal of Clinical Medicine pediatric patient severely injured patient volume–outcome relationship hospital volume centralization |
| title | Correlation between Hospital Volume of Severely Injured Patients and In-Hospital Mortality of Severely Injured Pediatric Patients in Japan: A Nationwide 5-Year Retrospective Study |
| title_full | Correlation between Hospital Volume of Severely Injured Patients and In-Hospital Mortality of Severely Injured Pediatric Patients in Japan: A Nationwide 5-Year Retrospective Study |
| title_fullStr | Correlation between Hospital Volume of Severely Injured Patients and In-Hospital Mortality of Severely Injured Pediatric Patients in Japan: A Nationwide 5-Year Retrospective Study |
| title_full_unstemmed | Correlation between Hospital Volume of Severely Injured Patients and In-Hospital Mortality of Severely Injured Pediatric Patients in Japan: A Nationwide 5-Year Retrospective Study |
| title_short | Correlation between Hospital Volume of Severely Injured Patients and In-Hospital Mortality of Severely Injured Pediatric Patients in Japan: A Nationwide 5-Year Retrospective Study |
| title_sort | correlation between hospital volume of severely injured patients and in hospital mortality of severely injured pediatric patients in japan a nationwide 5 year retrospective study |
| topic | pediatric patient severely injured patient volume–outcome relationship hospital volume centralization |
| url | https://www.mdpi.com/2077-0383/10/7/1422 |
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