The Association between Comorbidities and Comorbid Injuries on Treatment Outcome in Pediatric and Elderly Patients with Injuries in Korea: An Observational Study
Abstract
:1. Introduction
2. Materials and Methods
3. Results
3.1. General Characteristics of Patients with Injury
3.2. Characteristics of Injuries
3.3. The Main Diagnoses of Patients with Injury
3.4. Subdiagnosis of Patients with Injury
3.5. Factors Associated with Surgery in Patients with Injury
3.6. Factors Associated with LOS in Patients with Injury
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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0–12 Years (n = 11,842) | ≥65 Years (n = 35,686) | p-Value † | |||
---|---|---|---|---|---|
n | % | n | % | ||
Sex | <0.001 | ||||
Male | 7627 | 64.4 | 14,107 | 39.5 | |
Female | 4215 | 35.6 | 21,579 | 60.5 | |
Admission route | <0.001 | ||||
Emergency department | 7484 | 63.2 | 23,543 | 66.0 | |
Outpatient department | 4342 | 36.7 | 12,119 | 34.0 | |
Others | 16 | 0.1 | 24 | 0.1 | |
Insurance type | <0.001 | ||||
NHI | 8863 | 74.8 | 25,153 | 70.5 | |
Medicaid | 384 | 3.2 | 3444 | 9.7 | |
Others | 2595 | 21.9 | 7089 | 19.9 | |
Treatment outcome | <0.001 | ||||
Improved | 11,543 | 97.5 | 33,076 | 92.7 | |
Not improved | 144 | 1.2 | 996 | 2.8 | |
Diagnosis only | 112 | 0.9 | 688 | 1.9 | |
Others | 7 | 0.1 | 65 | 0.2 | |
Death | 36 | 0.3 | 861 | 2.4 | |
Number of hospital beds | <0.001 | ||||
100–299 | 3819 | 32.2 | 16,774 | 47.0 | |
300–499 | 1846 | 15.6 | 4779 | 13.4 | |
500–999 | 4986 | 42.1 | 12,039 | 33.7 | |
≥1000 | 1191 | 10.1 | 2094 | 5.9 | |
Surgery | 0.191 | ||||
No | 6313 | 53.3 | 19,271 | 54.0 | |
Yes | 5529 | 46.7 | 16,415 | 46.0 | |
Length of stay | <0.001 ‡ | ||||
Mean ± standard deviation | 7.6 | 10.1 | 18.5 | 27.3 | |
Year of injury (children/elderly) * | <0.001 | ||||
2006 (0.02%/0.08%) | 1661 | 14.0 | 3400 | 9.5 | |
2007 (0.02%/0.07%) | 1456 | 12.3 | 3143 | 8.8 | |
2008 (0.01%/0.06%) | 1199 | 10.1 | 3149 | 8.8 | |
2009 (0.01%/0.06%) | 1061 | 9.0 | 2999 | 8.4 | |
2010 (0.01%/0.06%) | 1181 | 10.0 | 3298 | 9.2 | |
2011 (0.01%/0.05%) | 1036 | 8.7 | 3015 | 8.4 | |
2012 (0.01%/0.05%) | 993 | 8.4 | 3071 | 8.6 | |
2013 (0.01%/0.04%) | 737 | 6.2 | 2584 | 7.2 | |
2014 (0.01%/0.04%) | 638 | 5.4 | 2500 | 7.0 | |
2015 (0.01%/0.04%) | 569 | 4.8 | 2385 | 6.7 | |
2016 (0.01%/0.03%) | 507 | 4.3 | 2341 | 6.6 | |
2017 (0.01%/0.05%) | 804 | 6.8 | 3801 | 10.7 |
0–12 Years (n = 11,842) | ≥65 Years (n = 35,686) | p-Value † | |||
---|---|---|---|---|---|
n | % | n | % | ||
Intentionality | <0.001 | ||||
Unintentional | 11,711 | 98.9 | 34,410 | 96.4 | |
Intentional self-harm | 9 | 0.1 | 800 | 2.2 | |
Violence | 89 | 0.8 | 279 | 0.8 | |
Unidentified/under investigation | 29 | 0.2 | 163 | 0.5 | |
Unknown | 4 | 0.0 | 34 | 0.1 | |
Place of injury | <0.001 | ||||
Home | 3406 | 28.8 | 10,397 | 29.1 | |
Road/highway | 3073 | 26 | 10,289 | 28.8 | |
Unknown | 2810 | 23.7 | 10,038 | 28.1 | |
Farm | 16 | 0.1 | 1177 | 3.3 | |
Water, ocean, outdoors | 183 | 1.5 | 825 | 2.3 | |
Healthcare facility | 25 | 0.2 | 512 | 1.4 | |
Industrial, construction sites | 13 | 0.1 | 484 | 1.4 | |
Commercial areas | 255 | 2.2 | 471 | 1.3 | |
Group residential facility | 16 | 0.1 | 464 | 1.3 | |
Other | 186 | 1.6 | 354 | 1 | |
Play, cultural, and public Facilities | 408 | 3.4 | 231 | 0.6 | |
Other traffic areas | 32 | 0.3 | 207 | 0.6 | |
School | 852 | 7.2 | 124 | 0.3 | |
Sports facilities and stadiums | 567 | 4.8 | 113 | 0.3 | |
Activity during injury occurrence | <0.001 | ||||
Unknown | 2757 | 23.3 | 12,437 | 34.9 | |
In daily life | 2773 | 23.4 | 8829 | 24.7 | |
While moving | 1460 | 12.3 | 5403 | 15.1 | |
During other specified activities | 1393 | 11.8 | 4271 | 12 | |
During paid work | 2 | 0 | 2107 | 5.9 | |
During unpaid work | 3 | 0 | 1051 | 2.9 | |
During a leisure activity | 2413 | 20.4 | 741 | 2.1 | |
During treatment | 20 | 0.2 | 412 | 1.2 | |
While drinking alcohol | 41 | 0.3 | 280 | 0.8 | |
During a sports game | 431 | 3.6 | 102 | 0.3 | |
During education | 549 | 4.6 | 53 | 0.1 | |
Mechanism of injury | <0.001 | ||||
Falling, slipping | 4102 | 34.6 | 19,812 | 55.5 | |
Traffic accident | 3178 | 26.8 | 9005 | 25.2 | |
Bumping | 1704 | 14.4 | 1771 | 5 | |
Poisoning | 244 | 2.1 | 1456 | 4.1 | |
Other | 485 | 4.1 | 1448 | 4.1 | |
Unknown | 161 | 1.4 | 1020 | 2.9 | |
Stabbing, cutting, severed | 417 | 3.5 | 557 | 1.6 | |
Fire, flame, heat | 1452 | 12.3 | 532 | 1.5 | |
Asphyxiation | 42 | 0.4 | 70 | 0.2 | |
Drowning | 46 | 0.4 | 14 | 0 | |
Gun shot | 10 | 0.1 | 1 | 0 | |
Sexual violence | 1 | 0 | 0 | 0 |
Main Diagnosis | |||||
---|---|---|---|---|---|
0–12 years (n = 11,842) | ≥65 Years (n = 35,686) | ||||
Cases | % | Cases | % | ||
S70–S79 | Injuries to the hip and thigh | 325 | 2.7 | 6401 | 17.9 |
S00–S09 | Injuries to the head | 3324 | 28.1 | 6280 | 17.6 |
S30–S39 | Injuries to the abdomen, lower back, and pelvis | 456 | 3.9 | 5305 | 14.9 |
S20–S29 | Injuries to the thorax | 106 | 0.9 | 5175 | 14.5 |
S80–S89 | Injuries to the knee and lower leg | 1049 | 8.9 | 2727 | 7.6 |
S50–S59 | Injuries to the elbow and lower arm | 958 | 8.1 | 2172 | 6.1 |
S40–S49 | Injuries to the shoulder and upper arm | 1576 | 13.3 | 1895 | 5.3 |
S10–S19 | Injuries to the neck | 272 | 2.3 | 1180 | 3.3 |
S60–S69 | Injuries to the wrist and hands | 860 | 7.3 | 1093 | 3.1 |
T51–T65 | Toxic effects of substances chiefly nonmedicinal as to source | 120 | 1 | 985 | 2.8 |
S90–S99 | Injuries to the ankle and foot | 667 | 5.6 | 853 | 2.4 |
T20–T32 | Burns and corrosions | 1555 | 13.1 | 594 | 1.7 |
T36–T50 | Poisoning by, adverse effect of, and underdosing of drugs, medicaments, and biological substances | 118 | 1 | 471 | 1.3 |
T00–T07 | Injuries involving multiple body regions | 57 | 0.5 | 173 | 0.5 |
T15–T19 | Effects of foreign body entering through natural orifice | 272 | 2.3 | 158 | 0.4 |
T66–T78 | Other and unspecified effects of external causes | 89 | 0.8 | 99 | 0.3 |
T08–T14 | Injuries to the unspecified part of trunk and limbs | 29 | 0.2 | 93 | 0.3 |
T79 | Certain early complications of trauma | 8 | 0.1 | 29 | 0.1 |
T33–T35 | Frostbite | 1 | 0 | 3 | 0 |
Subdiagnosis | 0–12 Years (n = 11,842) | ≥65 Years (n = 35,686) | p-Value | |||
---|---|---|---|---|---|---|
Cases | % | Cases | % | |||
Subdiagnosis | <0.001 | |||||
No | 10,396 | 87.8 | 17,827 | 50.0 | ||
Yes | 1446 | 12.2 | 17,859 | 50.0 | ||
Disease codes | ||||||
A00–B99 | 165 | 1.4 | 1267 | 3.6 | <0.001 | |
C00–D48 | 10 | 0.1 | 762 | 2.1 | ||
D50–D89 | 69 | 0.6 | 940 | 2.6 | ||
E00–E90 | 24 | 0.2 | 5349 | 15.0 | ||
F00–F99 | 60 | 0.5 | 2173 | 6.1 | ||
G00–G99 | 112 | 0.9 | 1660 | 4.7 | ||
H00–H59 | 78 | 0.7 | 614 | 1.7 | ||
H60–H95 | 57 | 0.5 | 314 | 0.9 | ||
I00–I99 | 37 | 0.3 | 10,508 | 29.4 | ||
J00–J99 | 744 | 6.3 | 3181 | 8.9 | ||
K00–K93 | 151 | 1.3 | 3248 | 9.1 | ||
L00–L99 | 97 | 0.8 | 834 | 2.3 | ||
M00–M99 | 69 | 0.6 | 6042 | 16.9 | ||
N00–N99 | 27 | 0.2 | 2415 | 6.8 | ||
P00–P96 | 14 | 0.1 | 0 | 0.0 | ||
Q00–Q99 | 34 | 0.3 | 24 | 0.1 | ||
R00–R99 | 137 | 1.2 | 1218 | 3.4 | ||
T80–T88 | 47 | 0.4 | 282 | 0.8 | ||
T90–T98 | 4 | 0.0 | 100 | 0.3 | ||
U00–U19 | 7 | 0.1 | 80 | 0.2 | ||
Injury code | <0.001 | |||||
Single | 7491 | 63.3 | 21,762 | 61.0 | ||
Multiple | 4351 | 36.7 | 13,924 | 39.0 |
Variables | 0–12 Years (n = 11,842) | ≥65 Years (n = 35,686) | ||||
---|---|---|---|---|---|---|
aOR | 95% CI | aOR | 95% CI | |||
Sex | ||||||
Men | 1.194 | 1.101 | 1.295 | 0.796 | 0.76 | 0.834 |
Women | Ref. | Ref. | ||||
Admission route | ||||||
Emergency department | 0.391 | 0.122 | 1.252 | 0.916 | 0.393 | 2.136 |
Outpatient department | 0.625 | 0.195 | 1.999 | 0.877 | 0.376 | 2.046 |
Others | Ref. | Ref. | ||||
Insurance type | ||||||
NHI | 2.719 | 2.447 | 3.022 | 1.993 | 1.873 | 2.121 |
Medicaid | 2.719 | 2.164 | 3.417 | 1.573 | 1.437 | 1.722 |
Others | Ref. | Ref. | ||||
Treatment outcome | ||||||
Improved | 2.221 | 0.37 | 13.321 | 5.125 | 2.761 | 9.514 |
Not improved | 0.521 | 0.081 | 3.335 | 0.927 | 0.486 | 1.767 |
Diagnosis only | 0.139 | 0.019 | 1.004 | 0.39 | 0.197 | 0.769 |
Death | 3.15 | 0.46 | 21.573 | 2.883 | 1.529 | 5.437 |
Others | Ref. | Ref. | ||||
Number of hospital beds | ||||||
≥1000 | 2.074 | 1.797 | 2.394 | 2.659 | 2.407 | 2.938 |
500–999 | 1.74 | 1.584 | 1.912 | 1.989 | 1.89 | 2.093 |
300–499 | 0.982 | 0.869 | 1.109 | 1.395 | 1.303 | 1.492 |
100–299 | Ref. | Ref. | ||||
Injury code | ||||||
Multiple | 0.514 | 0.472 | 0.559 | 0.584 | 0.557 | 0.613 |
Single | Ref. | Ref. | ||||
Subdiagnosis | ||||||
Yes | 0.578 | 0.511 | 0.653 | 1.164 | 1.113 | 1.217 |
No | Ref. | Ref. |
Variables | 0–12 Years (n = 11,842) | ≥65 Years (n = 35,686) | ||||
---|---|---|---|---|---|---|
β | t | p-Value | β | t | p-Value | |
Intercept | 5.227532 | 1.23 | 0.2184 | 14.03701 | 2.26 | 0.0239 |
Sex | ||||||
Men | −0.19788 | −1.1 | 0.271 | −1.08321 | −3.77 | 0.0002 |
Women | Ref. | Ref. | ||||
Admission route | ||||||
Emergency department | 3.437655 | 1.47 | 0.1424 | 0.220338 | 0.04 | 0.9668 |
Outpatient department | 1.598193 | 0.68 | 0.4954 | −4.65999 | −0.88 | 0.3788 |
Others | Ref. | Ref. | ||||
Insurance type | ||||||
NHI | −4.83614 | −21.69 | <0.0001 | −9.4027 | −24.99 | <0.0001 |
Medicaid | −2.94505 | −5.71 | <0.0001 | −5.52255 | −9.88 | <0.0001 |
Others | Ref. | Ref. | ||||
Treatment outcome | ||||||
Improved | 0.272504 | 0.08 | 0.9386 | 2.962697 | 0.92 | 0.3575 |
Not improved | −3.89227 | −1.07 | 0.2825 | −2.90815 | −0.88 | 0.381 |
Diagnosis only | −3.62249 | −0.99 | 0.3203 | −3.25628 | −0.97 | 0.333 |
Death | −5.77275 | −1.49 | 0.1353 | 2.061551 | 0.62 | 0.5362 |
Others | Ref. | Ref. | ||||
Number of hospital beds | ||||||
≥1000 | −1.78143 | −5.59 | <0.0001 | −3.78238 | −6.18 | <0.0001 |
500–999 | −1.29049 | −6.12 | <0.0001 | −1.6089 | −4.97 | <0.0001 |
300–499 | 0.063464 | 0.24 | 0.8128 | 1.410254 | 3.3 | 0.001 |
100–299 | Ref. | Ref. | ||||
Injury code | ||||||
Multiple | 3.889958 | 20.38 | <0.0001 | 5.039694 | 16.54 | <0.0001 |
Single | Ref. | Ref. | ||||
Subdiagnosis | ||||||
Yes | 5.837476 | 22.01 | <0.0001 | 8.649975 | 31.03 | <0.0001 |
No | Ref. | Ref. | ||||
Surgery | ||||||
Yes | 3.952947 | 21.36 | <0.0001 | 11.11277 | 38.24 | <0.0001 |
No | Ref. | Ref. | ||||
R2 | 0.150434 | 0.097606 | ||||
F-value | 139.6 | 257.21 | ||||
p-value | <0.0001 | <0.0001 |
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Lee, K.; Hwang, J. The Association between Comorbidities and Comorbid Injuries on Treatment Outcome in Pediatric and Elderly Patients with Injuries in Korea: An Observational Study. Int. J. Environ. Res. Public Health 2022, 19, 6277. https://doi.org/10.3390/ijerph19106277
Lee K, Hwang J. The Association between Comorbidities and Comorbid Injuries on Treatment Outcome in Pediatric and Elderly Patients with Injuries in Korea: An Observational Study. International Journal of Environmental Research and Public Health. 2022; 19(10):6277. https://doi.org/10.3390/ijerph19106277
Chicago/Turabian StyleLee, Kyunghee, and Jieun Hwang. 2022. "The Association between Comorbidities and Comorbid Injuries on Treatment Outcome in Pediatric and Elderly Patients with Injuries in Korea: An Observational Study" International Journal of Environmental Research and Public Health 19, no. 10: 6277. https://doi.org/10.3390/ijerph19106277