Table 3.
Treatments and interventions of trauma patients according to the hospital ranking (hospital performance)
| Hospital outlier status | ||||
|---|---|---|---|---|
| Low-mortality | Average-mortality | High-mortality | P value | |
| Number of institutions | 39 | 72 | 40 | |
| Number of patients | 37,073 | 102,368 | 44,773 | |
| Blood transfusion within 24 h | 5613 (15.4) | 13,472 (13.5) | 6276 (14.3) | < 0.01 |
| Emergency procedures | ||||
| Oral intubation | 2982 (8.0) | 9246 (9.0) | 5589 (12.5) | < 0.01 |
| Nasal intubation | 42 (0.1) | 184 (0.2) | 114 (0.3) | < 0.01 |
| Cricothyroidotomy | 44 (0.1) | 114 (0.1) | 60 (0.1) | 0.51 |
| Ventilator use | 2925 (7.9) | 6904 (6.7) | 4562 (10.2) | < 0.01 |
| Closed CPR | 44 (0.1) | 165 (0.2) | 80 (0.2) | 0.09 |
| Open CPR | 14 (0.04) | 55 (0.1) | 5 (0.01) | < 0.01 |
| Aortic cross clamping | 14 (0.04) | 46 (0.04) | 14 (0.03) | 0.47 |
| REBOA | 73 (0.2) | 295 (0.3) | 137 (0.3) | < 0.01 |
| Thoracentesis | 63 (0.2) | 181 (0.2) | 128 (0.3) | < 0.01 |
| Chest drainage | 2012 (5.4) | 6187 (6.0) | 2867 (6.4) | < 0.01 |
| Pericardial puncture | 18 (0.1) | 47 (0.1) | 24 (0.1) | 0.83 |
| Pericardial fenestration | 12 (0.03) | 32 (0.03) | 12 (0.03) | 0.88 |
| Shock pants use | 8 (0.02) | 20 (0.02) | 5 (0.01) | 0.46 |
| Tourniquet use | 40 (0.1) | 171 (0.17) | 99 (0.22) | < 0.01 |
| Emergency craterization | 240 (0.7) | 678 (0.7) | 372 (0.8) | < 0.01 |
| Emergency TAE | 868 (2.3) | 3407 (3.3) | 1270 (2.8) | < 0.01 |
| Central venous line use | 1247 (3.4) | 3235 (3.2) | 2141 (4.8) | < 0.01 |
| Blood transfusion within 24 h | 2754 (7.4) | 8176 (8.0) | 3608 (8.1) | < 0.01 |
| Vasopressor use | 454 (1.2) | 1321 (1.3) | 819 (1.8) | < 0.01 |
| Open spine traction | 76 (0.2) | 177 (0.2) | 117 (0.3) | < 0.01 |
| Open bone traction | 1834 (5.0) | 5571 (5.4) | 4650 (10.4) | < 0.01 |
| External skeletal fixation | 864 (2.3) | 3043 (3.0) | 1390 (3.1) | < 0.01 |
| Other emergency bone fixation | 1911 (5.2) | 4389 (4.3) | 1625 (3.6) | < 0.01 |
| Primary surgeries | ||||
| Craniotomy | 1410 (3.8) | 3785 (3.7) | 1751 (3.9) | 0.14 |
| Craterization | 708 (1.9) | 1505 (1.5) | 610 (1.4) | < 0.01 |
| Thoracotomy | 211 (0.6) | 655 (0.6) | 289 (0.7) | 0.281 |
| Celiotomy | 1156 (3.1) | 2920 (2.9) | 1229 (2.8) | < 0.01 |
| Bone reduction and fixation | 14,059 (37.9) | 36,124 (35.3) | 15,418 (34.5) | < 0.01 |
| Revascularization | 203 (0.6) | 471 (0.5) | 215 (0.5) | 0.12 |
| TAE | 1169 (3.2) | 3170 (3.1) | 1423 (3.2) | 0.69 |
| Endoscopic surgery | 85 (0.2) | 157 (0.2) | 78 (0.2) | 0.01 |
| Replantation of limbs and digits | 131 (0.4) | 298 (0.3) | 183 (0.4) | < 0.01 |
| Hemostasis | 598 (1.6) | 1221 (1.2) | 609 (1.4) | < 0.01 |
| Others | 1925 (5.2) | 3973 (3.9) | 2073 (4.6) | < 0.01 |
| Secondary surgeries | ||||
| Craniotomy | 225 (0.6) | 490 (0.5) | 205 (0.5) | < 0.01 |
| Craterization | 55 (0.2) | 119 (0.1) | 41 (0.1) | 0.06 |
| Thoracotomy | 40 (0.1) | 79 (0.1) | 25 (0.1) | 0.03 |
| Celiotomy | 193 (0.5) | 406 (0.4) | 159 (0.4) | < 0.01 |
| Bone reduction and fixation | 497 (1.4) | 1142 (1.1) | 431 (1.0) | < 0.01 |
| Revascularization | 10 (0.03) | 31 (0.03) | 17 (0.04) | 0.66 |
| TAE | 104 (0.3) | 219 (0.22) | 87 (0.2) | 0.02 |
| Endoscopic surgery | 7 (0.02) | 7 (0.01) | 6 (0.01) | 0.14 |
| Hemostasis | 31 (0.1) | 98 (0.1) | 53 (0.1) | 0.28 |
| Any interventions | 23,770 (64.1) | 62,326 (60.9) | 28,083 (62.7) | < 0.01 |
| Any emergency procedures | 9993 (27.0) | 30,011 (29.3) | 16,037 (35.8) | < 0.01 |
| Any primary surgeries | 20,281 (54.7) | 51,652 (50.0) | 22,553 (50.4) | < 0.01 |
| Any secondary surgeries | 1079 (2.9) | 2420 (2.4) | 952 (2.1) | < 0.01 |
Emergency procedures: procedures performed during the emergency department stayed. Primary surgeries: surgeries performed at the first time. Any interventions = any primary surgeries or any secondary surgeries or any emergency procedures. Missing data: blood transfusion = 3891, primary surgeries (craniotomy = 158, craterization = 157, thoracotomy = 159, celiotomy = 159, bone reduction and fixation = 150, revascularization = 157, TAE = 157, endoscopic surgery = 159, replantation of limbs and digits = 159, hemostasis = 158, others = 155), secondary surgeries (craniotomy = 2011, craterization = 2011, thoracotomy = 2011, celiotomy = 2010, bone reduction and fixation = 2009, revascularization = 2011, TAE = 2011, endoscopic surgery = 2011, hemostasis = 2011)
CPR cardiopulmonary resuscitation, REBOA resuscitative endovascular balloon occlusion of the aorta, TAE transcatheter arterial embolization