| Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access |
| Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc |
| Journal website http://www.jocmr.org |
Original Article
Volume 8, Number 2, February 2016, pages 84-89
Impact of Starting an Emergency Medicine Residency Program on Overall Mortality Rate in a Regional Trauma Center
Tables
| Year | Author | Outcome |
|---|---|---|
| 1989 | Buchwald et al [2] | No change |
| 1990 | Rich et al [3] | Increase in LOS, no other changes |
| 1993 | Rich et al [4] | Increase for internal medicine patients, no other changes |
| 1995 | Shulkin et al [5] | No change |
| 2001 | Claridge et al [6] | No change |
| 2003 | Barry et al [7] | No change |
| 2003 | Myles [8] | No change |
| 2004 | Borenstein et al [9] | No change |
| 2004 | Finkielman et al [10] | No change |
| 2005 | Chow et al [11] | Increase in near miss errors in lab blood test requests |
| 2006 | Kestle et al [12] | Change for some outcomes related to shunt surgery |
| 2007 | Ford et al [13] | No change |
| Before residents (n = 1,316) | During residents (n = 1,391) | P value | |
|---|---|---|---|
| Age (years) | 40.36 ± 0.50 | 40.21 ± 0.48 | 0.97 |
| Mechanism of injury | |||
| Blunt (%) | 82.3 | 80.4 | |
| Penetrating (%) | 16.2 | 17.7 | 0.19 |
| Thermal (%) | 1.5 | 1.9 | |
| Injury severity score (overall) | 8.27 ± 0.23 | 9.05 ± 0.23 | 0.02 |
| < 15 (%) | 82.8 | 80.7 | |
| 15 - 24 (%) | 11.3 | 12.7 | 0.35 |
| ≥ 25 (%) | 5.9 | 6.6 |
| Before EM residents (n = 1,316) | During EM residents (n = 1,391) | P value | |
|---|---|---|---|
| *Patients that did not have times recorded for ED arrival and departure in their records were excluded for this analysis: before residents (n = 1,110); after residents (n = 1,293). | |||
| Length of stay in ICU (n) | 1.88 ± 0.13 | 2.09 ± 0.14 | 0.26 |
| Length of stay in hospital (n) | 5.28 ± 0.20 | 5.20 ± 0.20 | 0.12 |
| Morbidities (%) | 7.83 | 7.26 | 1.00 |
| Mortalities (%) | 2.81 | 2.01 | 0.18 |
| Time spent in ED* (min) | 236.83 ± 4.53 | 297.40 ± 5.55 | 0.00 |
| Age-adjusted coefficient | P value | Multiple covariate adjusted coefficient* | P value | |
|---|---|---|---|---|
| *Multiple covariate adjusted coefficient and P-value includes age, mechanism of injury and ISS. **Logistic regression analysis was calculated for mortality whereas linear regression analyses were calculated for the hospital length of stay, ICU length of stay, morbidity, and time in ED. | ||||
| Hospital length of stay | -0.01 | 0.79 | -0.02 | 0.18 |
| ICU length of stay | 0.02 | 0.26 | -0.00 | 0.90 |
| Morbidity | -0.01 | 0.69 | -0.03 | 0.17 |
| Mortality ** | -0.34 | 0.18 | -0.81 | 0.01 |
| Time in ED | 0.17 | 0.00 | 0.18 | 0.00 |
| N (before, during residents) | Before EM residents | During EM residents | P value | |
|---|---|---|---|---|
| Length of stay in ICU (n) | ||||
| ISS < 15 | 1,090; 1,122 | 1.03 ± 0.09 | 1.09 ± 0.09 | 0.06 |
| ISS 15 - 24 | 148; 177 | 4.57 ± 0.62 | 4.59 ± 0.45 | 0.88 |
| ISS ≥ 25 | 77; 92 | 8.60 ± 1.24 | 9.48 ± 1.24 | 0.61 |
| Length of stay in hospital (n) | ||||
| ISS < 15 | 1,090; 1,122 | 4.27 ± 0.15 | 4.13 ± 0.17 | 0.01 |
| ISS 15 - 24 | 148; 177 | 8.62 ± 0.88 | 8.16 ± 0.62 | 0.91 |
| ISS ≥ 25 | 77; 92 | 12.91 ± 1.64 | 12.57 ± 1.43 | 0.81 |
| Morbidities (%) | ||||
| ISS < 15 | 1,090; 1,122 | 3.0% | 2.0% | 0.38 |
| ISS 15 - 24 | 148; 177 | 20.0% | 19.0% | 0.99 |
| ISS ≥ 25 | 77; 92 | 53.0% | 51.0% | 0.90 |
| Mortalities (%) | ||||
| ISS < 15 | 1,090; 1,122 | 0.3% | 0.0% | 0.30 |
| ISS 15 - 24 | 148; 177 | 5.0% | 3.0% | 0.54 |
| ISS ≥ 25 | 77; 92 | 35% | 23.0% | 0.08 |
| Time spent in ED (min) | ||||
| ISS < 15 | 918; 1,040 | 240.99 ± 4.89 | 312.06 ± 6.39 | 0.00 |
| ISS 15 - 24 | 130; 168 | 227.45 ± 15.72 | 275.27 ± 13.03 | 0.00 |
| ISS ≥ 25 | 66; 89 | 182.80 ± 15.22 | 154.44 ± 10.46 | 0.18 |