ABSTRACT
BACKGROUND: Limited research exists examining the predictors of suicide attempts by mechanism. OBJECTIVE: The purpose of this study was to examine predictors of traumatic suicide attempts in youth. METHODS: Data came from patients 5-18 years of age presenting because of a suicide attempt at 2 hospitals in Central Texas with level I trauma centers. Univariate logistic regression examined the association between traumatic suicide attempts and variables describing the patient's demographic, mental health, and social information. We used the Mann-Whitney U test to examine the association between traumatic suicide attempts and the continuous variable of age. RESULTS: Of 231 patients included in this study, most were female (75.8%), non-Hispanic white (48.1%), and had a median age of 15.0 years (interquartile range 14-16). Compared with patients presenting because of an intentional overdose, patients presenting because of traumatic suicide attempts were associated with a reported criminal history (odds ratio [OR] 14.50 [95% confidence interval {CI} 3.84-54.82]), reported Child Protective Services history (OR 3.26 [95% CI 0.99-10.77]), being publicly insured or uninsured (OR 1.80 [95% CI 1.02-3.19]), male (OR 2.37 [95% CI 1.28-4.38]), and identifying as Hispanic (OR 2.01 [95% CI 1.10-3.68). CONCLUSIONS: Our findings inform targeted preventative resources and education efforts to populations of greatest need.
Subject(s)
Suicide, Attempted , Trauma Centers , Adolescent , Child , Female , Hospitals , Humans , Logistic Models , Male , Risk Factors , Texas/epidemiologyABSTRACT
Patient specific instrumentation (PSI) has recently been developed as a replacement for traditional instrumentation in total knee arthroplasty (TKA). The study aim was to assess efficiency via the mean total OR time using the PSI versus computer-assisted (CAS) TKAs with accuracy as a secondary endpoint. Sixty patients were randomized to CAS or PSI. A formula was developed to derive a profit ratio (PR) that incorporated costs, revenue, and total OR time. The PSI cases were 1.45 times more profitable than CAS allowing for approximately 3 PSI cases versus 2 CAS cases in one 8 hour OR day. Results from this series show that PSI improves OR efficiency, but does not improve accuracy.
Subject(s)
Arthroplasty, Replacement, Knee/economics , Arthroplasty, Replacement, Knee/instrumentation , Knee Prosthesis/economics , Operating Rooms/economics , Osteoarthritis, Knee/surgery , Surgery, Computer-Assisted/economics , Adult , Aged , Arthroplasty, Replacement, Knee/methods , Health Expenditures , Hospital Costs , Humans , Middle Aged , Models, Econometric , Operating Rooms/organization & administration , Operative Time , Osteoarthritis, Knee/economics , Outcome Assessment, Health Care/economics , Surgery, Computer-Assisted/methods , Treatment Outcome , Young AdultABSTRACT
Three hundred and eighty computer-assisted total knee arthroplasty cases were reviewed for accuracy of mechanical alignment. The 331 patients in the first set, designated Group A, showed a consistent valgus error of 1° from neutral alignment. It was hypothesized that a manual 1° varus correction during femur resection would yield a significantly greater level of accuracy in the second set of 49 patients, designated Group B. A mechanical alignment of ±3° was achieved in 91% of the uncalibrated Group A patients, which was significantly lower (p = 0.035) than the rate of 98% achieved in the calibrated Group B. Further statistical analysis of the data showed the time expenditure was not significantly changed once a new target value was recalibrated. By quantifying mean errors of measures at an early timeframe, enhanced accuracy in CAS can be achieved.
