Regional variation in hospital mortality and 30-day mortality for injured medicare patients

Adam S. Gorra, David E. Clark, Richard J. Mullins, Michael A. DeLorenzo

    Research output: Contribution to journalArticlepeer-review

    11 Scopus citations

    Abstract

    Background: We sought to evaluate how survival of older patients with injuries differs by geographic region within the United States. Methods: We analyzed Medicare fee-for-service records for patients aged 65 years and older with principal injury diagnoses (ICD-9 800-959, excluding 905, 930-939, 958). Cases were classified by Maximum Abbreviated Injury Score (AISmax) and Charlson Comorbidity score (0, 1, 2, ≥3). Hospital mortality and 30-day mortality were modeled as functions of age, sex, AISmax, comorbidity, and geographic region (northeast, midwest, south, west). Results: Hospital and 30-day mortality were both higher with male sex and increased age, AISmax, or Charlson score. Adjusted hospital mortality was highest in the northeast and south, but 30-day adjusted mortality was lowest in the same two regions. Conclusions: Regional differences in risk-adjusted hospital survival for older patients with injuries are different from regional differences in 30-day survival. Hospital mortality as an outcome for older injured patients should be interpreted cautiously.

    Original languageEnglish (US)
    Pages (from-to)954-959
    Number of pages6
    JournalWorld journal of surgery
    Volume32
    Issue number6
    DOIs
    StatePublished - Jun 1 2008

    ASJC Scopus subject areas

    • Surgery

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