Nav: Home

Gunshot victims in Cook County 'under-triaged' to community hospitals

January 18, 2017

Only one in six Cook County gunshot patients with injuries serious enough for treatment in a designated trauma center are taken to these specialized hospitals, according to a new report in JAMA Surgery.

The study also found these 'undertriaged' patients are more likely to live on the south and west sides of the county.

Researchers at the University of Illinois at Chicago School of Public Health looked at firearm-related injuries in Illinois' most populous county from 2009 through 2013. Inpatient and outpatient cases were analyzed.

Undertriaged patients were those who met the national criteria for transfer to a specialized trauma center but instead were taken to a hospital without one. The criteria are based on severity of the injury and its location, especially between the knees and top of head and from the elbows inward.

During the five years studied, there were nearly 10,000 firearm-related injuries in the county, of which 29 percent were initially treated at non-designated trauma centers, or community hospitals. Of the nearly 5,000 injuries serious enough for treatment at a trauma center, 18 percent were first treated at a non-trauma center, and only 10 percent were transferred to any of the county's 19 designated trauma centers.

The researchers found that patients treated in non-trauma centers were less likely to die than the patients treated in hospitals with trauma centers.

"This is likely because patients treated in these community-based hospitals have less serious injuries," said Lee Friedman, associate professor of environmental and occupational health sciences, UIC School of Public Health and corresponding author on the paper.

Friedman said that one of the reasons patients whose injuries meet criteria for treatment at trauma centers aren't treated at these facilities is because many are transported to the nearest hospital by friends or family.

"Friends and family don't follow guidelines for who should get transferred to a Level 1 or Level 2 trauma center, only emergency responders are expected to follow these criteria for where to bring and injured patient," Friedman said. "Additionally, EMS personnel sometimes bypass Level 1 or Level 2 trauma centers because those hospitals have signaled that their emergency departments are currently full. It happens all the time," Friedman said.

Friedman and his colleagues also found that a higher proportion of patients on the south and west sides of Cook County who met criteria for treatment in a designated trauma center were brought to community hospitals.

South of 99th Street, Friedman said, "there are no trauma centers, and many of the cities have very limited EMS resources. So the fact that many of these residents aren't treated at a trauma center is not surprising."

"On the west side of the county, which includes the west side of Chicago, the relatively high number of gunshot patients brought to non-trauma centers can be attributed to the sheer volume of gunshot injuries experienced in that area," he said.

Friedman said the data suggest that better communication between hospitals with and without specialized trauma teams is needed, so that patients can be swiftly transferred to a higher level of care if necessary.
-end-
Dr. Allison Lale and Allison Krajewski of the UIC School of Public Health are co-authors on the paper.

University of Illinois at Chicago

Related Public Health Articles:

Public health guidelines aim to lower health risks of cannabis use
Canada's Lower-Risk Cannabis Use Guidelines, released today with the endorsement of key medical and public health organizations, provide 10 science-based recommendations to enable cannabis users to reduce their health risks.
Study clusters health behavior groups to broaden public health interventions
A new study led by a University of Kansas researcher has used national health statistics and identified how to cluster seven health behavior groups based on smoking status, alcohol use, physical activity, physician visits and flu vaccination are associated with mortality.
Public health experts celebrate 30 years of CDC's prevention research solutions for communities with health disparities
It has been 30 years since CDC created the Prevention Research Centers (PRC) Program, currently a network of 26 academic institutions across the US dedicated to moving new discoveries into the communities that need them.
Public health experts support federally mandated smoke-free public housing
In response to a new federal rule mandating smoke-free policies in federally funded public housing authorities, three public health experts applaud the efforts of the US Department of Housing and Urban Development to protect nonsmoking residents from the harmful effects of tobacco exposure.
The Lancet Public Health: UK soft drinks industry levy estimated to have significant health benefits, especially among children
The UK soft drinks industry levy, due to be introduced in April 2018, is estimated to have significant health benefits, especially among children, according to the first study to estimate its health impact, published in The Lancet Public Health.
Social sciences & health innovations: Making health public
The international conference 'Social Sciences & Health Innovations: Making Health Public' is the third event organized as a collaborative endeavor between Maastricht University, the Netherlands, and Tomsk State University, the Russian Federation, with participation from Siberian State Medical University (the Russian Federation).
Columbia Mailman School Awards Public Health Prize to NYC Health Commissioner Dr. Mary T.
Dr. Mary T. Bassett, Commissioner of the New York City Department of Health and Mental Hygiene, was awarded the Frank A.
Poor health literacy a public health issue
America's poor record on health literacy is a public health issue, but one that can be fixed -- not by logging onto the internet but by increased interaction with your fellow human beings, a Michigan State University researcher argues.
Despite health law's bow to prevention, US public health funding is dropping: AJPH study
Although the language of the Affordable Care Act emphasizes disease prevention -- for example, mandating insurance coverage of clinical preventive services such as mammograms -- funding for public health programs to prevent disease have actually been declining in recent years.
'Chemsex' needs to become a public health priority
Chemsex -- sex under the influence of illegal drugs -- needs to become a public health priority, argue experts in The BMJ this week.

Related Public Health Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Setbacks
Failure can feel lonely and final. But can we learn from failure, even reframe it, to feel more like a temporary setback? This hour, TED speakers on changing a crushing defeat into a stepping stone. Guests include entrepreneur Leticia Gasca, psychology professor Alison Ledgerwood, astronomer Phil Plait, former professional athlete Charly Haversat, and UPS training manager Jon Bowers.
Now Playing: Science for the People

#524 The Human Network
What does a network of humans look like and how does it work? How does information spread? How do decisions and opinions spread? What gets distorted as it moves through the network and why? This week we dig into the ins and outs of human networks with Matthew Jackson, Professor of Economics at Stanford University and author of the book "The Human Network: How Your Social Position Determines Your Power, Beliefs, and Behaviours".