Insurance status predicts survival for trauma patients undergoing urgent intervention

• Published in: The Journal of surgical research 2014-05, Vol.188 (1), p.238-242
• Main Authors: Falor, Annie, MD, Kim, Dennis, MD, Bricker, Scott, MD, Neville, Angela, MD, Bongard, Frederic, MD, Putnam, Brant, MD, Plurad, David, MD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Exploratory laparotomy; Female; Health insurance; Humans; In-extremis; Insurance Coverage - statistics & numerical data; Laparotomy - mortality; Male; Middle Aged; Resuscitation - mortality; Resuscitative thoracotomy; Retrospective Studies; Shock, Traumatic - mortality; Shock, Traumatic - surgery; Surgery; Thoracotomy - mortality; Trauma; United States - epidemiology; Young Adult
• ISSN: 0022-4804; 1095-8673
• DOI: 10.1016/j.jss.2013.12.003

Abstract Background The purpose of this study was to investigate the relationship between insurance status and outcomes for trauma patients presenting without vital signs undergoing urgent intervention. Materials and methods The National Trauma Data Bank was queried for patients presenting with a systolic blood pressure equal to zero and a Glasgow Coma Scale score of three (“clinically dead”), who underwent urgent thoracotomy and–or laparotomy (UTL). Insured patients were compared with uninsured (INS [−]) patients. Results There were 18,171 patients presenting clinically dead having a payment source documented. INS (−) patients were more likely to undergo UTL (5.4% [416–7704] versus 2.7% [285–10,467], 1.481 [1.390–1.577],