Table 3.
Characteristics of Patients Who Received EBP5 and EBP6a
| Characteristic | EBP5, No. (%) |
P value | EBP6, No. (%) |
P value | ||
|---|---|---|---|---|---|---|
| Nonadherence | Adherence | Nonadherence | Adherence | |||
| No. | 149 174 | 109 160 | 49 012 | 32 405 | ||
| Age, mean (SD), y | 48 (32–61) | 48 (31–61) | <.001 | 76 (70–83) | 76 (69–82) | <.001 |
| Male sex | 105 136 (70.5) | 81 590 (74.8) | <.001 | 26 629 (54.5) | 18 124 (56.0) | <.001 |
| Race/ethnicity | ||||||
| White | 109 065 (75.9) | 77 298 (73.5) | <.001 | 39 565 (84.8) | 27 481 (87.6) | <.001 |
| Black | 14 150 (9.8) | 13 909 (13.2) | 2287 (4.9) | 1438 (4.6) | ||
| Hispanic | 13 704 (9.5) | 9671 (9.2) | 2375 (5.1) | 1295 (4.1) | ||
| Asian | 2320 (1.6) | 1279 (1.2) | 1392 (3.0) | 560 (1.8) | ||
| Other | 4441 (3.1) | 2987 (2.8) | 1057 (2.3) | 587 (1.9) | ||
| Insurance | ||||||
| Medicaid | 15 929 (12.1) | 14 229 (14.3) | <.001 | 1095 (2.5) | 832 (2.7) | <.001 |
| Medicare | 21 161 (16.0) | 15 421 (15.5) | 28 198 (63.7) | 18 494 (60.4) | ||
| Private | 72 601 (55.0) | 51 884 (52.0) | 13 808 (31.2) | 10 681 (34.9) | ||
| Self-pay | 22 312 (16.9) | 18 278 (18.3) | 1193 (2.7) | 591 (1.9) | ||
| ISS, median (IQR) | 17.0 (12.0–24.0) | 21.0 (14.0–29.0) | <.001 | 13.0 (9.0–21.0) | 14.0 (9.0–20.0) | <.001 |
| Motor GCS score, median (IQR) | 6.0 (6.0–6.0) | 6.0 (5.0–6.0) | <.001 | 6.0 (6.0–6.0) | 6.0 (6.0–6.0) | <.001 |
| SBP, median (IQR), mm Hg | 134.0 (118.0–150.0) | 129.0 (109.0–146.0) | <.001 | 143.0 (123.0–162.0) | 144.0 (124.0–163.0) | <.001 |
| Respiratory rate, median (IQR), breaths/min | 18.0 (16.0–22.0) | 20.0 (16.0–24.0) | <.001 | 18.0 (16.0–20.0) | 18.0 (16.0–21.0) | <.001 |
| Rib fractures, median (IQR), No. | 4.0 (2.0–7.0) | 5.0 (2.0–8.0) | <.001 | 5.0 (4.0–7.0) | 5.0 (4.0–8.0) | <.001 |
| Hemothorax/pneumothorax | 149 174 (100) | 109 160 (100) | NA | 14 853 (30.3) | 11 422 (35.2) | <.001 |
| ACS-verified level | ||||||
| I | 56 528 (37.9) | 42 813 (39.2) | <.001 | 14 688 (30.0) | 10 847 (33.5) | <.001 |
| II | 28 454 (19.1) | 18 852 (17.3) | 10 774 (22.0) | 6157 (19.0) | ||
| III | 1935 (1.3) | 1142 (1.0) | 1399 (2.9) | 726 (2.2) | ||
| IV | 100 (0.1) | 36 (<1) | 41 (0.1) | 5 (<1) | ||
| Not distinguished | 62 157 (41.7) | 46 317 (42.4) | 22 110 (45.1) | 14 670 (45.3) | ||
| Hospital bed size, median (IQR), No. | 455 (324–640) | 467 (333–640) | <.001 | 446 (317–620) | 455 (321–600) | <.001 |
| Admission year | ||||||
| 2007 | 11 392 (7.6) | 8349 (7.6) | <.001 | 3677 (7.5) | 1160 (3.6) | <.001 |
| 2008 | 15 861 (10.6) | 11 515 (10.5) | 5561 (11.3) | 1987 (6.1) | ||
| 2009 | 18 237 (12.2) | 11 601 (10.6) | 6103 (12.5) | 2350 (7.3) | ||
| 2010 | 19 148 (12.8) | 13 541 (12.4) | 6691 (13.7) | 3216 (9.9) | ||
| 2011 | 16 254 (10.9) | 13 310 (12.2) | 5488 (11.2) | 3646 (11.3) | ||
| 2012 | 22 205 (14.9) | 16 168 (14.8) | 7033 (14.3) | 5309 (16.4) | ||
| 2013 | 22 153 (14.9) | 16 691 (15.3) | 7139 (14.6) | 6464 (19.9) | ||
| 2014 | 23 924 (16.0) | 17 985 (16.5) | 7320 (14.9) | 8273 (25.5) | ||
Abbreviations: ACS, American College of Surgeons; EBP, evidence-based practice; GCS, Glasgow Coma Scale; IQR, interquartile range; ISS, Injury Severity Score; NA, not applicable; SBP, systolic blood pressure.
a
EBP5: chest tube placement for patients with hemothorax/pneumothorax; EBP6: chest tomographic scan for patients aged 65 years or older with multiple (≥3) rib fractures.