LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 10 of total 48

Search options

  1. Article ; Online: Social Determinants of Poor Outcomes Following Frostbite Injury: A Study of the National Inpatient Sample.

    Endorf, Frederick W / Nygaard, Rachel M

    Journal of burn care & research : official publication of the American Burn Association

    2021  Volume 42, Issue 6, Page(s) 1261–1265

    Abstract: Severe frostbite injury can result in significant disability from amputation of limbs and digits which may be mitigated through prompt medical care. The reported rates of amputation vary widely between centers. Our aim was to describe the incidence and ... ...

    Abstract Severe frostbite injury can result in significant disability from amputation of limbs and digits which may be mitigated through prompt medical care. The reported rates of amputation vary widely between centers. Our aim was to describe the incidence and factors associated with amputation secondary to frostbite injury in the United States using a national sample of hospitalizations. Admissions for frostbite injury were identified in the National Inpatient Sample (2016-2018). Factors associated with amputation were assessed by multivariable logistic regression and clustered by hospital. The overall incidence of frostbite injury in the United States is 0.83 of 100,000 people. Of the social factors associated with frostbite injury, homelessness and the black race were independently associated with a higher likelihood of amputation at the primary admission. Diagnosis of cellulitis was a predictor of amputation. Homeless frostbite patients were more frequently discharged against medical advice and were less likely to discharge with supportive medical care, despite having a higher rate of more severe injury. Disability from amputation following frostbite injury affects at least 20% of frostbite-injured patients and disproportionally affects the homeless population. Further study is needed to ascertain the decision making that leads to early amputation following frostbite injury, especially in the homeless and black population. Outreach and education efforts should be initiated to promote salvage of functional limb length following frostbite injury.
    MeSH term(s) Adult ; Amputation/statistics & numerical data ; Debridement/methods ; Female ; Frostbite/diagnosis ; Frostbite/therapy ; Humans ; Male ; Middle Aged ; Negative-Pressure Wound Therapy/methods ; Social Determinants of Health ; Thrombolytic Therapy/methods ; United States
    Language English
    Publishing date 2021-05-27
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2224246-6
    ISSN 1559-0488 ; 1559-047X
    ISSN (online) 1559-0488
    ISSN 1559-047X
    DOI 10.1093/jbcr/irab115
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 6223: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  2. Article ; Online: Socioeconomic and Comorbid Factors Associated With Frostbite Injury in the United States.

    Endorf, Frederick W / Nygaard, Rachel M

    Journal of burn care & research : official publication of the American Burn Association

    2021  Volume 43, Issue 3, Page(s) 646–651

    Abstract: Frostbite largely affects the extremities and often results in long-term disability due to amputation. More regions are experiencing extremes in temperature which increases the risk of frostbite injury. The aim of this study was to detail social and ... ...

    Abstract Frostbite largely affects the extremities and often results in long-term disability due to amputation. More regions are experiencing extremes in temperature which increases the risk of frostbite injury. The aim of this study was to detail social and comorbid factors associated with frostbite injury compared to isolated hand or foot burns. We used the National Inpatient Sample from 2016 to 2018 to identify admissions included in this study. Weighted incidence and multivariable analysis assessed characteristics and outcomes of frostbite and isolated hand or foot burn injury. In the United States, the estimated incidence of frostbite injury in those aged 15 and older was 0.95 per 100,000 persons and 4.44 per 100,000 persons with isolated hand and foot burns. Homelessness, mental health disorder, drug or alcohol abuse, and peripheral vascular disease were all associated with the risk of frostbite injury when compared to burn injury. We found that other insurance was associated with amputation following burn injury, while black race and homelessness were associated with amputation during a nonelective primary admission following frostbite injury. The differing risk factors associated with early amputation in frostbite and burn patients warrant a multicenter study including burn centers in North America.
    MeSH term(s) Amputation ; Burns/epidemiology ; Burns/therapy ; Foot Injuries ; Frostbite/epidemiology ; Humans ; Socioeconomic Factors ; United States/epidemiology ; Upper Extremity
    Language English
    Publishing date 2021-08-24
    Publishing country England
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2224246-6
    ISSN 1559-0488 ; 1559-047X
    ISSN (online) 1559-0488
    ISSN 1559-047X
    DOI 10.1093/jbcr/irab162
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 6223: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  3. Article ; Online: High Cost and Resource Utilization of Frostbite Readmissions in the United States.

    Endorf, Frederick W / Nygaard, Rachel M

    Journal of burn care & research : official publication of the American Burn Association

    2021  Volume 42, Issue 5, Page(s) 857–864

    Abstract: Frostbite is a high morbidity, high-cost injury that can lead to digit or limb necrosis requiring amputation. Our primary aim is to describe the rate of readmission following frostbite injury. Our secondary aims are to describe the overall burden of care, ...

    Abstract Frostbite is a high morbidity, high-cost injury that can lead to digit or limb necrosis requiring amputation. Our primary aim is to describe the rate of readmission following frostbite injury. Our secondary aims are to describe the overall burden of care, cost, and characteristics of repeat hospitalizations of frostbite-injured people. Hospitalizations following frostbite injury (index and readmissions) were identified in the 2016 and 2017 Nationwide Readmission Database. Multivariable logistic regression was clustered by hospital and additionally adjusted for severe frostbite injury, gender, year, payor group, severity, and comorbidity index. Population estimates were calculated and adjusted for by using survey weight, sampling clusters, and stratum. In the 2-year cohort, 1065 index hospitalizations resulted in 1907 total hospitalizations following frostbite injury. Most patients were male (80.3%), lived in metropolitan/urban areas (82.3%), and nearly half were insured with Medicaid (46.4%). Of the 842 readmissions, 53.7% were associated with complications typically associated with frostbite injury. Overall, 29% of frostbite injuries resulted in at least one amputation. The average total cost and total length of stay of readmissions were $236,872 and 34.7 days. Drug or alcohol abuse, homelessness, Medicaid insurance, and discharge against medical advice (AMA) were independent predictors of unplanned readmission. Factors associated with multiple readmissions include discharge AMA and Medicare insurance, but not drug or alcohol abuse or homelessness. The population-based estimated unplanned readmission rate following frostbite injury was 35.4% (95% confidence interval 32.2%-38.6%). This is the first study examining readmissions following frostbite injury on a national level. Drug or alcohol abuse, homelessness, Medicaid insurance, and discharge AMA were independent predictors of unplanned readmission, while only AMA discharge and Medicare insurance were associated with multiple readmissions. Supportive resources (community and hospital-based) may reduce unplanned readmissions of frostbite-injured patients with those additional risk factors.
    MeSH term(s) Adult ; Aged ; Databases, Factual ; Female ; Frostbite/economics ; Frostbite/therapy ; Hospital Costs ; Humans ; Length of Stay/economics ; Length of Stay/statistics & numerical data ; Male ; Medicaid/economics ; Medicaid/statistics & numerical data ; Medicare/economics ; Middle Aged ; Patient Discharge/economics ; Patient Readmission/economics ; Patient Readmission/statistics & numerical data ; Retrospective Studies ; United States
    Language English
    Publishing date 2021-04-15
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2224246-6
    ISSN 1559-0488 ; 1559-047X
    ISSN (online) 1559-0488
    ISSN 1559-047X
    DOI 10.1093/jbcr/irab076
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 6223: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  4. Article ; Online: Hyperbaric Oxygen and Mortality in Burns With Inhalation Injury: A Study of the National Burn Repository.

    Nygaard, Rachel M / Endorf, Frederick W

    Journal of burn care & research : official publication of the American Burn Association

    2021  Volume 42, Issue 5, Page(s) 900–904

    Abstract: Mortality in burn injury is primarily influenced by three factors: age, percent burn (%TBSA), and presence of inhalation injury. Numerous modalities have been tried in an attempt to treat those patients with burns and inhalation injury, including the use ...

    Abstract Mortality in burn injury is primarily influenced by three factors: age, percent burn (%TBSA), and presence of inhalation injury. Numerous modalities have been tried in an attempt to treat those patients with burns and inhalation injury, including the use of hyperbaric oxygen (HBO). The aim of our study was to find the national prevalence of HBO for burns with inhalation injury, and whether HBO influenced mortality in these often severely injured patients. This retrospective study used the National Burn Repository (NBR) to identify hospital admissions of patients with both cutaneous burn and inhalation injuries. After applying exclusion criteria, a total of 13,044 patients were identified. Variables included in the multivariate regression analysis included age, sex, race, payer, mechanism of burn injury, TBSA group, total procedure number, mechanical ventilator days, and treatment with HBO. The main outcome variable was mortality. Of the 13,044 patients, 67 had HBO therapy. The HBO patients were older (mean age 51.7 vs 42.8 years, P < .001), but had smaller burns and thus a similar Baux score (66.6 vs 65.2, P = .661). The HBO patients had a higher mortality (29.9% vs 17.5%, P = .01). On multivariate regression analysis, HBO was an independent predictor of mortality (odds ratio = 2.484, P = .004). Other significant predictors of mortality included age, black race, Medicaid or uninsured patients, and %TBSA. The use of HBO for patients with burns and inhalation injury is uncommon in this database. It is unclear whether that reflects low prevalence or if individual centers do not all impute HBO into the NBR. For those patients in this database, HBO is an independent predictor of mortality. It can be difficult to determine the severity of inhalation injury in the NBR, so those patients receiving HBO could theoretically have more severe inhalation injury.
    MeSH term(s) Adult ; Body Surface Area ; Burn Units ; Burns/mortality ; Burns/therapy ; Cause of Death ; Humans ; Hyperbaric Oxygenation/mortality ; Injury Severity Score ; Length of Stay ; Male ; Middle Aged ; Registries ; Retrospective Studies ; Risk Assessment ; Smoke Inhalation Injury/mortality
    Language English
    Publishing date 2021-06-09
    Publishing country England
    Document type Journal Article
    ZDB-ID 2224246-6
    ISSN 1559-0488 ; 1559-047X
    ISSN (online) 1559-0488
    ISSN 1559-047X
    DOI 10.1093/jbcr/irab105
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 6223: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  5. Article ; Online: Firearm injury survival is only the beginning: The impact of socioeconomic factors on unplanned readmission after injury.

    Lumbard, Derek C / Richardson, Chad J / Endorf, Frederick W / Nygaard, Rachel M

    Injury

    2023  Volume 54, Issue 8, Page(s) 110893

    Abstract: Background: Firearm trauma remain a national crisis disproportionally impacting minority populations in the United States. Risk factors leading to unplanned readmission after firearm injury remain unclear. We hypothesized that socioeconomic factors have ...

    Abstract Background: Firearm trauma remain a national crisis disproportionally impacting minority populations in the United States. Risk factors leading to unplanned readmission after firearm injury remain unclear. We hypothesized that socioeconomic factors have a major impact on unplanned readmission following assault-related firearm injury.
    Methods: The 2016-2019 Nationwide Readmission Database of the Healthcare Cost and Utilization Project was used to identify hospital admissions in those aged >14 years with assault-related firearm injury. Multivariable analysis assessed factors associated with unplanned 90-day readmission.
    Results: Over 4 years, 20,666 assault-related firearm injury admissions were identified that resulted in 2,033 injuries with subsequent 90-day unplanned readmission. Those with readmissions tended to be older (31.9 vs 30.3 years), had a drug or alcohol diagnosis at primary hospitalization (27.1% vs 24.1%), and had longer hospital stays at primary hospitalization (15.5 vs 8.1 days) [all P<0.05]. The mortality rate in the primary hospitalization was 4.5%. Primary readmission diagnoses included: complications (29.6%), infection (14.5%), mental health (4.4%), trauma (15.6%), and chronic disease (30.6%). Over half of the patients readmitted with a trauma diagnosis were coded as new trauma encounters. 10.3% of readmission diagnoses included an additional 'initial' firearm injury diagnosis. Independent predictors of 90-day unplanned readmission were public insurance (aOR 1.21, P = 0.008), lowest income quartile (aOR 1.23, P = 0.048), living in a larger urban region (aOR 1.49, P = 0.01), discharge requiring additional care (aOR 1.61, P < 0.001), and discharge against medical advice (aOR 2.39, P < 0.001).
    Conclusions: Here we present socioeconomic risk factors for unplanned readmission after assault-related firearm injury. Better understanding of this population can lead to improved outcomes, decreased readmissions, and decreased financial burden on hospitals and patients. Hospital-based violence intervention programs may use this to target mitigating intervention programs in this population.
    MeSH term(s) Humans ; United States/epidemiology ; Patient Readmission ; Firearms ; Wounds, Gunshot/epidemiology ; Retrospective Studies ; Risk Factors ; Socioeconomic Factors ; Databases, Factual
    Language English
    Publishing date 2023-06-14
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 218778-4
    ISSN 1879-0267 ; 0020-1383
    ISSN (online) 1879-0267
    ISSN 0020-1383
    DOI 10.1016/j.injury.2023.110893
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 778: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)
    Zs.MO 10: Show issues

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  6. Article ; Online: Revision Surgery Following Severe Frostbite Injury Compared to Similar Hand and Foot Burns.

    Coward, Alexandra / Endorf, Frederick W / Nygaard, Rachel M

    Journal of burn care & research : official publication of the American Burn Association

    2022  

    Abstract: Severe frostbite is associated with loss of digits or limbs and high levels of morbidity. The current practice is to salvage as much of the limb/digit as possible with the use of thrombolytic and adjuvant therapies. Sequelae from amputation can include ... ...

    Abstract Severe frostbite is associated with loss of digits or limbs and high levels of morbidity. The current practice is to salvage as much of the limb/digit as possible with the use of thrombolytic and adjuvant therapies. Sequelae from amputation can include severe nerve pain and poor wound healing requiring revision surgery. The aim of this study was to examine the rate of revision surgery after primary amputation and compare this to revision surgery in isolated hand/foot burns. Frostbite and burn patients from 2014 to 2019 were identified in the prospectively maintained database at a single urban burn and trauma center. Patients with primary amputations related to isolated hand/foot burns or frostbite were included in the study. Descriptive statistics included Student's t-test and Fisher's exact test. A total of 63 patients, 54 frostbite injuries and 9 isolated hand or foot burns, met inclusion criteria for the study. The rate of revision surgery was similar following frostbite and burn injury (24% vs 33%, P = .681). There were no significant differences in age, sex, or length of stay on the primary hospitalization between those that required revision surgery and those that did not. Neither the impacted limb nor the presence of infection or cellulitis on primary amputation was associated with future need for revision surgery. Of the 16 patients requiring revision surgery, 5 (31%) required additional debridement alone, 6 (38%) required reamputation alone, and 5 required both. A total of 6 patients (38%) had cellulitis or infection at the time of revision surgery. Time from primary surgery to revision ranged from 4 days to 3 years. Planned, delayed primary amputation is a mainstay of frostbite management. To our knowledge, this is the first assessment of revision surgery in the setting of severe frostbite injury. Our observed rate of revision surgery following frostbite injury did not differ significantly from revision surgery in the setting of isolated hand or foot burns. This study brings up important questions of timing and surgical planning in these complex patients that will require a multicenter collaborative study.
    Language English
    Publishing date 2022-06-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 2224246-6
    ISSN 1559-0488 ; 1559-047X
    ISSN (online) 1559-0488
    ISSN 1559-047X
    DOI 10.1093/jbcr/irac082
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 6223: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  7. Article ; Online: Differences in Treatment of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis at Burn Centers and Nonburn Centers.

    Nygaard, Rachel M / Endorf, Frederick W

    Journal of burn care & research : official publication of the American Burn Association

    2020  Volume 41, Issue 5, Page(s) 945–950

    Abstract: Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and Stevens-Johnson/TEN overlap syndrome (SJS/TEN) are severe exfoliative skin disorders resulting primarily from allergic drug reactions and sometimes from viral causes. Because of the ... ...

    Abstract Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and Stevens-Johnson/TEN overlap syndrome (SJS/TEN) are severe exfoliative skin disorders resulting primarily from allergic drug reactions and sometimes from viral causes. Because of the significant epidermal loss in many of these patients, many of them end up receiving treatment at a burn center for expertise in the care of large wounds. Previous work on the treatment of this disease focused only on the differences in care of the same patients treated at nonburn centers and then transferred to burn centers. We wanted to explore whether patients had any differences in care or outcomes when they received definitive treatment at burn centers and nonburn centers. We queried the National Inpatient Sample database from 2016 for patients with SJS, SJS/TEN, and TEN diagnoses. We considered burn centers as those with greater than 10 burn transfers to their center and fewer than 5 burn transfers out of their center in a year. Multivariable logistic regression assessed factors associated with treatment at a burn center and mortality. Using the National Inpatient Sample, a total of 1164 patients were identified. These were divided into two groups, nonburn centers vs burn centers, and those groups were compared for demographic characteristics as well as variables in their hospital course and outcome. Patients treated at nonburn centers were more likely to have SJS and patients treated at burn centers were more likely to have both SJS/TEN and TEN. Demographics were similar between treatment locations, though African-Americans were more likely to be treated at a burn center. Burn centers had higher rates of patients with extreme severity and mortality risks and a longer length of stay. However, burn centers had similar actual mortality compared to nonburn centers. Patients treated at burn centers had higher charges and were more likely to be transferred to long-term care after their hospital stay. The majority of patients with exfoliative skin disorders are still treated at nonburn centers. Patients with SJS/TEN and TEN were more likely to be treated at a burn center. Patients treated at burn centers appear to have more severe disease but similar mortality to those treated at nonburn centers. Further study is needed to determine whether patients with these disorders do indeed benefit from transfer to a burn center.
    MeSH term(s) Adult ; Aged ; Burn Units ; Cohort Studies ; Female ; Hospitalization ; Humans ; Male ; Middle Aged ; Patient Transfer ; Practice Patterns, Physicians' ; Retrospective Studies ; Socioeconomic Factors ; Stevens-Johnson Syndrome/diagnosis ; Stevens-Johnson Syndrome/mortality ; Stevens-Johnson Syndrome/therapy ; Survival Rate
    Language English
    Publishing date 2020-06-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 2224246-6
    ISSN 1559-0488 ; 1559-047X
    ISSN (online) 1559-0488
    ISSN 1559-047X
    DOI 10.1093/jbcr/iraa082
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 6223: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  8. Article ; Online: Nonmedical Factors Influencing Early Deaths in Burns: A Study of the National Burn Repository.

    Nygaard, Rachel M / Endorf, Frederick W

    Journal of burn care & research : official publication of the American Burn Association

    2019  Volume 41, Issue 1, Page(s) 3–7

    Abstract: It is well-established that survival in burn injury is primarily dependent on three factors: age, percent total-body surface area burned (%TBSA), and inhalation injury. However, it is clear that in other (nonburn) conditions, nonmedical factors may ... ...

    Abstract It is well-established that survival in burn injury is primarily dependent on three factors: age, percent total-body surface area burned (%TBSA), and inhalation injury. However, it is clear that in other (nonburn) conditions, nonmedical factors may influence mortality. Even in severe burns, patients undergoing resuscitation may survive for a period of time before succumbing to infection or other complications. In some cases, though, families in conjunction with caregivers may choose to withdraw care and not resuscitate patients with large burns. We wanted to investigate whether any nonmedical socioeconomic factors influenced the rate of early deaths in burn patients. The National Burn Repository (NBR) was used to identify patients that died in the first 72 hours after injury and those that survived more than 72 hours. Both univariate and multivariate regression analyses were used to examine factors including age, gender, race, comorbidities, burn size, inhalation injury, and insurance type, and determine their influence on deaths within 72 hours. A total of 133,889 burn patients were identified, 1362 of which died in the first 72 hours. As expected, the Baux score (age plus burn size), and inhalation injury predicted early deaths. Interestingly, on multivariate analysis, patients with Medicare (p = .002), self-pay patients (p < .001), and those covered by automobile policies (p = .045) were significantly more likely to die early than those with commercial insurance. Medicaid patients were more likely to die early, but not significantly (p = .188). Worker's compensation patients were more likely to survive the first 72 hours compared with patients with commercial insurance (p < .001). Men were more likely to survive the early period than women (p = .043). On analysis by race, only Hispanic patients significantly differed from white patients, and Hispanics were more likely to survive the first 72 hours (p = .028). Traditional medical factors are major factors in early burn deaths. However, these results show that nonmedical socioeconomic factors including race, gender, and especially insurance status influence early burn deaths as well.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Burns/complications ; Burns/ethnology ; Burns/mortality ; Child ; Child, Preschool ; Databases, Factual ; Ethnic Groups/statistics & numerical data ; European Continental Ancestry Group/statistics & numerical data ; Female ; Humans ; Infant ; Infant, Newborn ; Insurance Coverage ; Insurance, Health ; Male ; Middle Aged ; Regression Analysis ; Risk Factors ; Socioeconomic Factors ; Survival Rate ; Time Factors ; United States/epidemiology ; Young Adult
    Language English
    Publishing date 2019-10-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 2224246-6
    ISSN 1559-0488 ; 1559-047X
    ISSN (online) 1559-0488
    ISSN 1559-047X
    DOI 10.1093/jbcr/irz139
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 6223: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  9. Article ; Online: Frostbite vs Burns: Increased Cost of Care and Use of Hospital Resources.

    Nygaard, Rachel M / Endorf, Frederick W

    Journal of burn care & research : official publication of the American Burn Association

    2018  Volume 39, Issue 5, Page(s) 676–679

    Abstract: Numerous demographic, socioeconomic, and injury factors influence a burn patient's hospital course. Compared to the typical burn patient, frostbite injury frequently impacts those with high rates of mental illness, substance abuse, and those suffering ... ...

    Abstract Numerous demographic, socioeconomic, and injury factors influence a burn patient's hospital course. Compared to the typical burn patient, frostbite injury frequently impacts those with high rates of mental illness, substance abuse, and those suffering homelessness. Our aim was to examine differences in the hospital course of frostbite patients compared to those with burns limited to the hands and feet. Patients with frostbite injury and those with isolated hand and/or foot burns were identified in the National Burn Repository. The database was cleaned based on published protocols. Patients were excluded if they had an inhalation injury recorded or unknown. Patients with frostbite injury were significantly older and more likely to be male. Frostbite patients were less frequently covered by commercial insurance (25.3% vs 41.7%). Mean total BSA (TBSA) did not differ between the two groups (frostbite: 2.1 and burn: 1.7, P = .195). The mean intensive care unit (ICU) days and requirement for mechanical ventilation were not significantly different between the two groups, however frostbite patients were significantly more likely to require ICU care (26.5% vs 13.7%, P = .002). Hospital length of stay (LOS) was significantly longer in frostbite patients (8.1 vs 4.0 days, P < .001) and hospital charges were significantly higher in frostbite patients ($43,400 vs $15,600, P < .001). Factors associated with increased hospital charges included mechanism, age, gender, race, TBSA, hospital LOS, ICU, and mechanical ventilation. Factors associated with increased LOS included mechanism, age, gender, race, TBSA, ICU stay, and mechanical ventilation. On multivariate analysis, all factors, except gender, remained independent predictors of increased hospital LOS. A comparison of similarly injured patients treated at burn centers showed frostbite injury as a significant predictor of increased LOS and hospital costs compared to burn-injured patients.
    MeSH term(s) Adolescent ; Adult ; Burns/economics ; Burns/therapy ; Child ; Databases, Factual ; Facilities and Services Utilization/economics ; Female ; Foot Injuries/economics ; Foot Injuries/therapy ; Frostbite/economics ; Frostbite/therapy ; Hand Injuries/economics ; Hand Injuries/therapy ; Health Care Costs ; Health Resources/economics ; Health Resources/statistics & numerical data ; Hospitalization/economics ; Hospitalization/statistics & numerical data ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Young Adult
    Language English
    Publishing date 2018-06-18
    Publishing country England
    Document type Comparative Study ; Journal Article
    ZDB-ID 2224246-6
    ISSN 1559-0488 ; 1559-047X
    ISSN (online) 1559-0488
    ISSN 1559-047X
    DOI 10.1093/jbcr/iry033
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 6223: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  10. Article ; Online: Frostbite in the United States: An Examination of the National Burn Repository and National Trauma Data Bank.

    Nygaard, Rachel M / Endorf, Frederick W

    Journal of burn care & research : official publication of the American Burn Association

    2018  Volume 39, Issue 5, Page(s) 780–785

    Abstract: Frostbite is a form of thermal injury that can have devastating consequences for patients, including digit amputations and sometimes more proximal amputations. To the best of the authors' knowledge, no one has determined national characteristics of ... ...

    Abstract Frostbite is a form of thermal injury that can have devastating consequences for patients, including digit amputations and sometimes more proximal amputations. To the best of the authors' knowledge, no one has determined national characteristics of frostbite patients, nor the prevalence of these diagnostic and therapeutic modalities. This is the first look at nationwide trends in the treatment of frostbite in the United States. Patients with frostbite injury were identified in the National Trauma Data Bank (NTDB) and National Burn Repository (NBR). Inclusion criteria were diagnosis codes of frostbite injury. The number of frostbite patients treated each year is relatively stable at NBR (N = 497) contributing centers. The NTDB (N = 388) has shown a trend toward increased numbers of frostbite patients. Both databases show an overwhelmingly male demographic (NBR 81.1%, NTDB 75.8%) with a predominance of lower extremity injury (NBR 47.9%, NTDB 66%). Hospital days were similar in both databases (NBR 10.7, NTDB 9.5). Both databases show that frostbite patients frequently require an intensive care unit (ICU) stay, with an average of 8.5 ICU days for NBR patients and 5.9 days for NTDB patients. Frostbite is often a severe disease process that results in relatively long hospital and ICU stays, as well as frequent significant surgeries including amputation. Often, patients afflicted with frostbite require discharge to skilled care before returning home. As more centers encounter patients with frostbite injury, the need for increased awareness of limb/digit saving treatment modalities should be addressed through education from national associations.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Burns/epidemiology ; Child ; Child, Preschool ; Databases, Factual ; Female ; Frostbite/diagnosis ; Frostbite/epidemiology ; Frostbite/therapy ; Humans ; Infant ; Infant, Newborn ; Injury Severity Score ; Intensive Care Units ; Length of Stay ; Male ; Middle Aged ; Prevalence ; Retrospective Studies ; Trauma Centers ; Treatment Outcome ; United States/epidemiology ; Young Adult
    Language English
    Publishing date 2018-07-26
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2224246-6
    ISSN 1559-0488 ; 1559-047X
    ISSN (online) 1559-0488
    ISSN 1559-047X
    DOI 10.1093/jbcr/irx048
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 6223: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

To top