Involvement of Surgical Residents in the Management of Trauma Patients in the Emergency Room: Does the Presence of an Attending ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2012-03

AUTHORS

Robert Cohen, Bruria Adini, Irina Radomislensky, Adi Givon, Avraham I. Rivkind, Kobi Peleg

ABSTRACT

BACKGROUND: Few studies have investigated whether the presence or absence of attending physicians (AP) in the emergency department (ED) during the management of trauma patients by residents. METHODS: Six level 1 trauma center admissions for years 2006-2008 were analyzed to determine whether presence of an AP affected the time spent in the ED, post-ED disposition, and in-hospital mortality. RESULTS: Patient demographics differed in relation to the presence of APs (P < 0.01). Patients with ISS > 25 who died during hospitalization were more often managed when APs were present. Male patients, those <65, and patients with Injury Severity Score (ISS) > 16 were more often treated in the presence of an AP (P < 0.01). Penetrating, terror trauma, motor vehicle collision and assaults were more often managed in the presence APs. Presence of APs differed by hospital (P < 0.0001). Adjusted logistic regression revealed that patients spent less time in the ED, went directly to the operating room or the ICU for definitive care, if an AP was present. CONCLUSIONS: Presence of an attending physician improved and focused patient triage, disposition decisions, and outcomes. More... »

PAGES

539-547

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00268-012-1428-0

DOI

http://dx.doi.org/10.1007/s00268-012-1428-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1012248783

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22270994


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52 schema:description BACKGROUND: Few studies have investigated whether the presence or absence of attending physicians (AP) in the emergency department (ED) during the management of trauma patients by residents. METHODS: Six level 1 trauma center admissions for years 2006-2008 were analyzed to determine whether presence of an AP affected the time spent in the ED, post-ED disposition, and in-hospital mortality. RESULTS: Patient demographics differed in relation to the presence of APs (P < 0.01). Patients with ISS > 25 who died during hospitalization were more often managed when APs were present. Male patients, those <65, and patients with Injury Severity Score (ISS) > 16 were more often treated in the presence of an AP (P < 0.01). Penetrating, terror trauma, motor vehicle collision and assaults were more often managed in the presence APs. Presence of APs differed by hospital (P < 0.0001). Adjusted logistic regression revealed that patients spent less time in the ED, went directly to the operating room or the ICU for definitive care, if an AP was present. CONCLUSIONS: Presence of an attending physician improved and focused patient triage, disposition decisions, and outcomes.
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