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Race, Sex, Age Impact Level-I Trauma Center Transfers

Non-clinical factors significantly affect hospital transfer

THURSDAY, Oct. 12 (HealthDay News) -- Even after controlling for injury severity, non-clinical factors such as race, gender, age and insurance status significantly impact a patient's risk for hospital transfer to level-I trauma centers, researchers report in the October issue of the Journal of Bone and Joint Surgery.

Kenneth J. Koval, M.D., of the Dartmouth-Hitchcock Medical Center in Lebanon, N.H., and colleagues performed a retrospective case-controlled study using data from the National Trauma Data Bank. A group of patients with Injury Severity Scores of 9 and lower transferred to a level-I trauma center from another hospital were compared with a control group with low Injury Severity Scores and who were treated at lower than level-I trauma centers and not transferred. Of the sample of 97,393 patients, 21 percent were transferred.

After adjusting for all risk factors, the odds ratios for transfer were higher for men than women (1.46). Children were more likely to be transferred than seniors (3.54) as were blacks compared to whites (1.28). Patients received at night compared to daytime (2.25), Medicaid patients (2.02) and patients with one or more comorbidities compared to those with no comorbidity (2.79) were also at risk for transfer.

"These results suggest the need for prospective studies to further investigate the relationships between hospital transfer and both medical and non-medical factors," the authors conclude.

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