澳大利亚医院外发生的创伤性脑损伤死亡的发生率和决定因素

IF 1.7 4区 医学 Q2 EMERGENCY MEDICINE
Gerard M O'Reilly MBBS, FACEM, MPH, MBiostat, AStat, PhD, Afsana Afroz PhD, Kate Curtis RN, PhD, Grad Dip Crit Care Nurs, MNurs(Hons), FCENA, Biswadev Mitra MBBS, MHSM, PhD, FACEM, Yesul Kim BA, Grad Dip Psychol, PhD, Emma Solly PhD, Courtney Ryder BScBEng(Biomed)(Hons), PhD, Kate Hunter BAppSc(Nursing), GradDipEd(Nurse Education), MPH, PhD, Delia V Hendrie BSc, BA, MA, PhD, Nick Rushworth BA(Hons), MA, AMusA, Jin Tee BMSC, MBBS, MD, FRACS, Mark C Fitzgerald MBBS, MD(Research), GradCertInet, FACEM, AFRACMA
{"title":"澳大利亚医院外发生的创伤性脑损伤死亡的发生率和决定因素","authors":"Gerard M O'Reilly MBBS, FACEM, MPH, MBiostat, AStat, PhD,&nbsp;Afsana Afroz PhD,&nbsp;Kate Curtis RN, PhD, Grad Dip Crit Care Nurs, MNurs(Hons), FCENA,&nbsp;Biswadev Mitra MBBS, MHSM, PhD, FACEM,&nbsp;Yesul Kim BA, Grad Dip Psychol, PhD,&nbsp;Emma Solly PhD,&nbsp;Courtney Ryder BScBEng(Biomed)(Hons), PhD,&nbsp;Kate Hunter BAppSc(Nursing), GradDipEd(Nurse Education), MPH, PhD,&nbsp;Delia V Hendrie BSc, BA, MA, PhD,&nbsp;Nick Rushworth BA(Hons), MA, AMusA,&nbsp;Jin Tee BMSC, MBBS, MD, FRACS,&nbsp;Mark C Fitzgerald MBBS, MD(Research), GradCertInet, FACEM, AFRACMA","doi":"10.1111/1742-6723.70051","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objective</h3>\n \n <p>To identify the determinants of death occurring outside of hospital following moderate to severe traumatic brain injury (msTBI) across Australia.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>Design, setting: Retrospective observational study using National Coronial Information System (NCIS) data. Participants: People who died during the five-year study period between 2015 and 2020 and were recorded in the NCIS as having intracranial injury as a cause or contributor to death. Major outcome measures: The primary outcome was the location of death, specifically whether death occurred outside an acute hospital setting.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>There were 3751 deaths with msTBI, of which 1064 (28.4%) occurred outside of an acute hospital setting and 605 (16.1%) occurred outside any medical service. The odds of death occurring outside hospital were lower for male patients (odds ratio [OR]: 0.6, 95% confidence interval [CI]: 0.5–0.7), penetrating injuries (OR 5.2, 95% CI: 3.0–8.9) and highest in the Northern Territory followed by Queensland. The odds of death occurring outside <i>any</i> medical service area (e.g. hospital, rehabilitation, nursing home) were higher for: younger adults (OR 3.6, 95% CI: 1.0–12.7), those with penetrating injuries (OR 8.9, 95% CI: 4.5–17.3), and where the time between injury and death was less than 24 h. The odds of death outside any medical service area were less for people with msTBI in South Australia (OR 0.1, 95% CI 0.0–0.2).</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>Approximately, one in six msTBI deaths occurred outside of any medical service area. Opportunities exist to improve access to emergency care for people sustaining msTBI across Australia.</p>\n </section>\n </div>","PeriodicalId":11604,"journal":{"name":"Emergency Medicine Australasia","volume":"37 3","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70051","citationCount":"0","resultStr":"{\"title\":\"The incidence and determinants of traumatic brain injury deaths occurring outside hospital in Australia\",\"authors\":\"Gerard M O'Reilly MBBS, FACEM, MPH, MBiostat, AStat, PhD,&nbsp;Afsana Afroz PhD,&nbsp;Kate Curtis RN, PhD, Grad Dip Crit Care Nurs, MNurs(Hons), FCENA,&nbsp;Biswadev Mitra MBBS, MHSM, PhD, FACEM,&nbsp;Yesul Kim BA, Grad Dip Psychol, PhD,&nbsp;Emma Solly PhD,&nbsp;Courtney Ryder BScBEng(Biomed)(Hons), PhD,&nbsp;Kate Hunter BAppSc(Nursing), GradDipEd(Nurse Education), MPH, PhD,&nbsp;Delia V Hendrie BSc, BA, MA, PhD,&nbsp;Nick Rushworth BA(Hons), MA, AMusA,&nbsp;Jin Tee BMSC, MBBS, MD, FRACS,&nbsp;Mark C Fitzgerald MBBS, MD(Research), GradCertInet, FACEM, AFRACMA\",\"doi\":\"10.1111/1742-6723.70051\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objective</h3>\\n \\n <p>To identify the determinants of death occurring outside of hospital following moderate to severe traumatic brain injury (msTBI) across Australia.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>Design, setting: Retrospective observational study using National Coronial Information System (NCIS) data. Participants: People who died during the five-year study period between 2015 and 2020 and were recorded in the NCIS as having intracranial injury as a cause or contributor to death. Major outcome measures: The primary outcome was the location of death, specifically whether death occurred outside an acute hospital setting.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>There were 3751 deaths with msTBI, of which 1064 (28.4%) occurred outside of an acute hospital setting and 605 (16.1%) occurred outside any medical service. The odds of death occurring outside hospital were lower for male patients (odds ratio [OR]: 0.6, 95% confidence interval [CI]: 0.5–0.7), penetrating injuries (OR 5.2, 95% CI: 3.0–8.9) and highest in the Northern Territory followed by Queensland. The odds of death occurring outside <i>any</i> medical service area (e.g. hospital, rehabilitation, nursing home) were higher for: younger adults (OR 3.6, 95% CI: 1.0–12.7), those with penetrating injuries (OR 8.9, 95% CI: 4.5–17.3), and where the time between injury and death was less than 24 h. The odds of death outside any medical service area were less for people with msTBI in South Australia (OR 0.1, 95% CI 0.0–0.2).</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>Approximately, one in six msTBI deaths occurred outside of any medical service area. Opportunities exist to improve access to emergency care for people sustaining msTBI across Australia.</p>\\n </section>\\n </div>\",\"PeriodicalId\":11604,\"journal\":{\"name\":\"Emergency Medicine Australasia\",\"volume\":\"37 3\",\"pages\":\"\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-05-02\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1742-6723.70051\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Emergency Medicine Australasia\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1111/1742-6723.70051\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"EMERGENCY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Emergency Medicine Australasia","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/1742-6723.70051","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"EMERGENCY MEDICINE","Score":null,"Total":0}
引用次数: 0

摘要

目的确定澳大利亚中重度创伤性脑损伤(msTBI)后院外死亡的决定因素。方法设计、设置:采用国家冠状动脉信息系统(NCIS)数据进行回顾性观察研究。参与者:在2015年至2020年的五年研究期间死亡的人,这些人在NCIS中被记录为颅内损伤是导致死亡的原因或因素。主要结局指标:主要结局指标是死亡地点,特别是死亡是否发生在急性医院环境之外。结果msTBI死亡3751例,其中1064例(28.4%)发生在急性医院外,605例(16.1%)发生在任何医疗机构外。男性患者院外死亡的几率较低(比值比[OR]: 0.6, 95%可信区间[CI]: 0.5-0.7),穿透性损伤(比值比[OR]: 5.2, 95%可信区间[CI]: 3.0-8.9),最高的是北领地,其次是昆士兰。在任何医疗服务区域(如医院、康复中心、养老院)之外发生死亡的几率较高的是:年轻成人(OR 3.6, 95% CI: 1.0-12.7)、穿透性损伤(OR 8.9, 95% CI: 4.5-17.3),以及受伤和死亡之间的时间少于24小时。南澳大利亚msTBI患者在任何医疗服务区域外死亡的几率都较低(OR为0.1,95% CI为0.0-0.2)。大约六分之一的msTBI死亡发生在任何医疗服务区域之外。在澳大利亚各地,有机会改善维持msTBI的人获得紧急护理的机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

The incidence and determinants of traumatic brain injury deaths occurring outside hospital in Australia

The incidence and determinants of traumatic brain injury deaths occurring outside hospital in Australia

Objective

To identify the determinants of death occurring outside of hospital following moderate to severe traumatic brain injury (msTBI) across Australia.

Methods

Design, setting: Retrospective observational study using National Coronial Information System (NCIS) data. Participants: People who died during the five-year study period between 2015 and 2020 and were recorded in the NCIS as having intracranial injury as a cause or contributor to death. Major outcome measures: The primary outcome was the location of death, specifically whether death occurred outside an acute hospital setting.

Results

There were 3751 deaths with msTBI, of which 1064 (28.4%) occurred outside of an acute hospital setting and 605 (16.1%) occurred outside any medical service. The odds of death occurring outside hospital were lower for male patients (odds ratio [OR]: 0.6, 95% confidence interval [CI]: 0.5–0.7), penetrating injuries (OR 5.2, 95% CI: 3.0–8.9) and highest in the Northern Territory followed by Queensland. The odds of death occurring outside any medical service area (e.g. hospital, rehabilitation, nursing home) were higher for: younger adults (OR 3.6, 95% CI: 1.0–12.7), those with penetrating injuries (OR 8.9, 95% CI: 4.5–17.3), and where the time between injury and death was less than 24 h. The odds of death outside any medical service area were less for people with msTBI in South Australia (OR 0.1, 95% CI 0.0–0.2).

Conclusion

Approximately, one in six msTBI deaths occurred outside of any medical service area. Opportunities exist to improve access to emergency care for people sustaining msTBI across Australia.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Emergency Medicine Australasia
Emergency Medicine Australasia 医学-急救医学
CiteScore
3.70
自引率
13.00%
发文量
217
审稿时长
6-12 weeks
期刊介绍: Emergency Medicine Australasia is the official journal of the Australasian College for Emergency Medicine (ACEM) and the Australasian Society for Emergency Medicine (ASEM), and publishes original articles dealing with all aspects of clinical practice, research, education and experiences in emergency medicine. Original articles are published under the following sections: Original Research, Paediatric Emergency Medicine, Disaster Medicine, Education and Training, Ethics, International Emergency Medicine, Management and Quality, Medicolegal Matters, Prehospital Care, Public Health, Rural and Remote Care, Technology, Toxicology and Trauma. Accepted papers become the copyright of the journal.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信