
@article{ref1,
title="Regional Variation in Hospital Mortality and 30-day Mortality for Injured Medicare Patients",
journal="World journal of surgery",
year="2008",
author="Gorra, Adam S. and Clark, David E. and Mullins, R. J. and Delorenzo, Michael A.",
volume="32",
number="6",
pages="954-959",
abstract="BACKGROUND: We sought to evaluate how survival of older patients with injuries differs by geographic region within the United States. METHODS: We analyzed Medicare fee-for-service records for patients aged 65 years and older with principal injury diagnoses (ICD-9 800-959, excluding 905, 930-939, 958). Cases were classified by Maximum Abbreviated Injury Score (AISmax) and Charlson Comorbidity score (0, 1, 2,>/=3). Hospital mortality and 30-day mortality were modeled as functions of age, sex, AISmax, comorbidity, and geographic region (northeast, midwest, south, west). RESULTS: Hospital and 30-day mortality were both higher with male sex and increased age, AISmax, or Charlson score. Adjusted hospital mortality was highest in the northeast and south, but 30-day adjusted mortality was lowest in the same two regions. CONCLUSIONS: Regional differences in risk-adjusted hospital survival for older patients with injuries are different from regional differences in 30-day survival. Hospital mortality as an outcome for older injured patients should be interpreted cautiously.<p /> <p>Language: en</p>",
language="en",
issn="0364-2313",
doi="10.1007/s00268-007-9410-y",
url="http://dx.doi.org/10.1007/s00268-007-9410-y"
}