title: Admission patterns of an urban level I trauma center.
abstract: Because trauma admission and hospitalization patterns have profound effects on the organization and utilization of urban trauma-care systems, the objective of this study was to identify and analyze these patterns. As an example, admissions to an urban Level I trauma center were reviewed. Retrospective review of all 2029 trauma admissions to a Level I trauma center was conducted from 1993 to 1996. The result was that most trauma patients were young (40% < 30 years of age) and male (74%). Mechanisms of injury were motor vehicle accident (36%), fall (27%), gunshot (17%), stab (7%), assault (6%), and swimming or diving accident (3%). Half of the patients were directly admitted from the scene. Injury Severity Score, length of stay, and mortality were 14.1 +/- 0.3, 10.5 +/- 0.3 days, and 5.1%, respectively. Admissions tended to occur more frequently between 4:00 PM and midnight (46%), between Friday and Sunday (52%), and between July and October (41%). The following patterns were identified: admissions per year decreased (-21%) because of reduced penetrating trauma (-43%, P < .01); pediatric patients (< 15 years) had similar incidence of penetrating trauma as adults (ages 15-45). Length of stay for all mechanisms of injury was not statistically different; most mortalities occurred within the first day (33%, P < .01) or after 6 days (36%, P < .01); early mortality was mainly due to penetrating injury (74%, P < .01), whereas late mortality was related to blunt trauma (92%, P < .01). The conclusion was that admission and demographic patterns were identified, which may be useful in the utilization, modification, and future design of trauma systems.
authors.affiliation: Department of Surgery, Jefferson Medical College, Philadelphia, Pa., USA.
authors.forename: P
authors.initials: P
authors.lastname: Ovadia
authors.forename: D
authors.initials: D
authors.lastname: Szewczyk
authors.forename: K
authors.initials: K
authors.lastname: Walker
authors.forename: F
authors.initials: F
authors.lastname: Abdullah
authors.forename: S
authors.initials: S
authors.lastname: Schmidt-Gillespie
authors.forename: R
authors.initials: R
authors.lastname: Rabinovici
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003627:Data Interpretation, Statistical; D005260:Female; D006785:Hospitals, University; D006786:Hospitals, Urban; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010343:Patient Admission / Q000706:statistics & numerical data*; D015143:Philadelphia / Q000453:epidemiology; D012189:Retrospective Studies; D012621:Seasons; D012737:Sex Factors; D013997:Time Factors; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy; D014949:Wounds, Nonpenetrating / Q000453:epidemiology; D014950:Wounds, Penetrating / Q000453:epidemiology