Associations between cardiovascular comorbidities and mortality, length of hospital stay, and total charges among traumatic injury patients
- 9 Downloads
Cardiovascular conditions are highly prevalent and particularly common in subsets of the population at high risk for traumatic injury. This study evaluates the extent to which cardiovascular comorbidity may increase risks of negative outcomes in patients receiving trauma treatment.
Clinical data for all patients admitted for traumatic injury (defined by ICD-9 diagnosis codes) of all levels of severity between the years of 2006 and 2014 in the Detroit USA metropolitan area were obtained from the State Inpatient Database for Michigan. The association between four types of cardiovascular comorbidity (hypertension, congestive heart failure, pulmonary circulation disorders, and valvular heart disease), and three outcomes (mortality, length of hospital stay, and total charges), was assessed using generalized linear modeling, both alone and after controlling for injury severity, injury region, and demographic factors.
All four comorbidities examined were related to worse outcomes on all three dimensions. The greatest magnitude of estimated effects with each outcome was associated with pulmonary circulation disorders (mortality OR = 2.99, length of stay IRR = 1.69, hospital charges IRR = 1.76), and the smallest magnitude of estimated effects was associated with hypertension (mortality OR = 1.20, length of stay IRR = 1.20, hospital charges IRR = 1.18). After adjustment for the presence of multiple comorbidities, injury severity and region, age, gender, and race, all effect estimates remained significant and in the same direction, except valvular heart disease which was unrelated to mortality, and hypertension was related to lower risk of mortality (OR = 0.76).
Cardiovascular comorbidities are related to higher risk of negative outcomes among patients hospitalized due to traumatic injury. Screening for these comorbidities on admission may help to improve patient outcomes.
KeywordsCardiovascular health Traumatic injury Risk factors Mortality
Compliance with ethical standards
Conflict of interest
Michael Yang, R. David Hayward, and Elango Edhayan declare that they have no conflict of interest.
- 1.World Health Organization. Injuries and violence: the facts. Geneva: WHO; 2014.Google Scholar
- 2.Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS) Nonfatal Injury Data [Internet]. 2017. www.cdc.gov/injury/wisqars Accessed 21 Sep 2018.
- 14.Healthcare Cost and Utilization Project. HCUP State Inpatient Databases (SID) [Internet]. Rockville, MD: Agency for Healthcare Research and Quality; 2014. www.hcup-us.ahrq.gov/sidoverview.jsp Accessed 15 June 2019.
- 17.London MJ, Schwartz GG, Hur K, Henderson WG. Association of perioperative statin use with mortality and morbidity after major noncardiac surgery association of perioperative statin use with mortality and morbidity association of perioperative statin use with mortality and morbidity. JAMA Intern Med. 2017;177:231–42.CrossRefGoogle Scholar
- 20.Eberhardt MS, Fryar CD, Hirsch R, Wright JD, Yoon SSug. Hypertension, high serum total cholesterol, and diabetes; racial and ethnic prevalence differences in U.S. adults, 1999–2006. National Center for Health Statistics (U.S.), editor. 2010. https://stacks.cdc.gov/view/cdc/5726 Accessed 18 June 2019.