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conferenceseries
.com
Volume 7, Issue 5 (Suppl)
Epidemiology (Sunnyvale), an open access journal
ISSN: 2161-1165
Epidemiology 2017
October 23-25, 2017
EPIDEMIOLOGY & PUBLIC HEALTH
October 23-25, 2017 | Paris, France
6
th
International Conference on
RISK FACTORS FOR 14-DAY REHOSPITALIZATION FOLLOWING TRAUMA WITH NEW
TRAUMATIC SPINAL CORD INJURY DIAGNOSIS: A 10-YEAR NATIONWIDE STUDY IN
TAIWAN
Carlos Lam
a
, Ping-Ling Chen
a
, Jiunn-Horng Kang
a
, Kuang-Fu Cheng
a
, Ray-Jade Chen
a
and
Kuo-Sheng Hung
a
a
Taipei Medical University, Taiwan
Objectives
: Fourteen-day rehospitalisation with new traumatic spinal cord injury (tSCI) diagnosis is used as an indicator for
the diagnostic quality of the first hospitalization. In this nationwide population-based cohort study, we identified risk factors
for this indicator.
Methods
: We performed a nested case–control study by including patients who had first hospitalization for trauma in
the National Health Insurance Research Database between 2001 and 2011. Variables including demographic and trauma
characteristics were compared between patients diagnosed with tSCI at the first hospitalization and those having 14-day
rehospitalisation with new tSCI diagnosis.
Results
: Of 23617 tSCI patients, 997 had 14-day rehospitalisation with new tSCI diagnosis (incidence rate, 4.22%). The risk of
14-day rehospitalisation with new tSCI diagnosis was significantly lower in patients with severe (injury severity score [ISS] =
16–24; odds ratio [OR], 0.17; 95% confidence interval [CI], 0.13–0.21) and profound (ISS > 24; OR, 0.11; 95% CI, 0.07–0.18)
injuries. Interhospital transfer (OR, 8.20; 95% CI, 6.48–10.38) was a significant risk factor, along with injuries at the thoracic
(OR, 1.62; 95% CI, 1.21–2.18), lumbar (OR, 1.30; 95% CI, 1.02–1.65), and multiple (OR, 3.23; 95% CI, 1.86–5.61) levels. Brain
(OR, 2.82), chest (OR, 2.99), and abdominal (OR, 2.74) injuries were also identified as risk factors. In addition, the risk was
higher in patients treated at the orthopaedic department (OR, 2.26; 95% CI, 1.78–2.87) and those of other surgical disciplines
(OR, 1.89; 95% CI, 1.57–2.28) than in those treated at the neurosurgery department.
Conclusions
: Delayed tSCI diagnoses are not uncommon, particularly among trauma patients with ISSs <16 or those
transferred from lower-level hospitals. Further validation and implementation of evidence-based decision rules is essential for
improving the diagnostic quality of traumatic thoracolumbar SCI.
Epidemiology (Sunnyvale) 2017, 7:5(Suppl)
DOI: 10.4172/2161-1165-C1-018