The effect of arrival time on emergency retention and prognosis in patients with severe trauma / 中华急诊医学杂志

ABSTRACT

Objective:To explore the relationship between arrival time and the retention in emergency room and the prognosis in patients with severe trauma.Methods:The clinical data of 1 738 emergency trauma patients in emergency intensive care from trauma center information system of the First Affiliated Hospital of Soochow University were extracted. The emergency retention was the time in the emergency room ≥ 4 h. The 24 h of the day was divided into three shifts at 800, 1500 and 2200. Logistic regression model was used to calculate the crude OR and adjusted OR after adjustment by age, sex and RTS of emergency shifts, and COX regression analysis was performed with emergency death as the endpoint. Results:Among the total of 1 738 patients with severe trauma, there were 852 (49.02%) cases of emergency retention. Taking the morning shift as the reference baseline, the risks of emergency retention in middle shift and night shift were increased gradually. The OR value of night shift was statistically significant ( P<0.01), and the crude OR and adjusted OR were 2.21 (95% CI 1.71-2.86) and 2.36 (95% CI 1.76-3.18), respectively. The univariate COX regression model indicated that the crude HR of night shift was statistically significant ( HR=0.26, 95% CI 0.08-0.90, P=0.033). However, the multivariate COX regression model showed no statistically significant differences in the adjusted HR of middle shift ( HR=0.96, 95% CI 0.43-2.14, P=0.914) and night shift ( HR=0.40, 95% CI 0.08-1.85, P=0.238), respectively. Conclusions:The arrival time of emergency trauma patients might be a contributor to the emergency retention, and night shift patients are more likely to encounter retention, but there is no significant effect on patient death.