Abstract:
Importance:Motor vehicle crashes (MVCs) are a leading public health concern. Emergency medical service (EMS) response time is a modifiable, system-level factor with the potential to influence trauma patient survival. The relationship between EMS response time and MVC mortality is unknown. Objectives:To measure the association between EMS response times and MVC mortality at the population level across US counties. Design, Setting, and Study Population:This population-based study included MVC-related deaths in 2268 US counties, representing an estimated population of 239 464 121 people, from January 1, 2013, through December 31, 2015. Data were analyzed from October 1, 2017, through April 30, 2018. Exposure:The median EMS response time to MVCs within each county (county response time), derived from data collected by the National Emergency Medical Service Information System. Main Outcomes and Measures:The county rate of MVC-related death, calculated using crash fatality data recorded in the Fatality Analysis Reporting System of the National Highway Traffic Safety Administration. Results:During the study period, 2 214 480 ambulance responses to MVCs were identified (median, 229 responses per county [interquartile range (IQR), 73-697 responses per county]) in 2268 US counties. The median county response time was 9 minutes (IQR, 7-11) minutes. Longer response times were significantly associated with higher rates of MVC mortality (≥12 vs <7 minutes; mortality rate ratio, 1.46; 95% CI, 1.32-1.61) after adjusting for measures of rurality, on-scene and transport times, access to trauma resources, and traffic safety laws. This finding was consistent in both rural/wilderness and urban/suburban settings, where a significant proportion of MVC fatalities (population attributable fraction: rural/wilderness, 9.9%; urban/suburban, 14.1%) were associated with prolonged response times (defined by the median value, ≥10 minutes and ≥7 minutes, respectively). Conclusions and Relevance:Among 2268 US counties, longer EMS response times were associated with higher rates of MVC mortality. A significant proportion of MVC-related deaths were associated with prolonged response times in both rural/wilderness and urban/suburban settings. These findings suggest that trauma system-level efforts to address regional disparities in MVC mortality should evaluate EMS response times as a potential contributor.
journal_name
JAMA Surgjournal_title
JAMA surgeryauthors
Byrne JP,Mann NC,Dai M,Mason SA,Karanicolas P,Rizoli S,Nathens ABdoi
10.1001/jamasurg.2018.5097subject
Has Abstractpub_date
2019-04-01 00:00:00pages
286-293issue
4eissn
2168-6254issn
2168-6262pii
2723267journal_volume
154pub_type
杂志文章相关文献
JAMA Surgery文献大全abstract:Importance:Identification of the tumor margin during surgery is important for precise minimal resection of lung tumors. Intravenous injection of indocyanine green (ICG) has several limitations when used for intraoperative visualization of lung cancer. Objectives:To describe a technique for intraoperative visualization...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2020.1314
更新日期:2020-06-24 00:00:00
abstract:IMPORTANCE:Laparoscopic ventral hernia repair (LVHR) using mesh is a well-established intervention for ventral hernia, but pain control can be challenging. OBJECTIVE:To determine whether instillation of a long-acting local anesthetic between the mesh and the peritoneum after LVHR reduces pain or narcotic requirements....
journal_title:JAMA surgery
pub_type: 杂志文章,随机对照试验
doi:10.1001/jamasurg.2015.1530
更新日期:2015-09-01 00:00:00
abstract:Importance:Older adults are disproportionately affected by trauma and accounted for 47% of trauma fatalities in 2016. In many populations and disease processes, described risk factors for poor clinical outcomes include sarcopenia and brain atrophy, but these remain to be fully characterized in older trauma patients. Sa...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2019.0988
更新日期:2019-08-01 00:00:00
abstract:Importance:Women are disproportionately underrecognized as award winners within medical societies. The presence of this disparity has not been investigated in training programs. Objective:To determine the presence of a gender disparity in award winners in general surgery residency programs. Design, Setting, and Parti...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2020.3518
更新日期:2020-09-02 00:00:00
abstract:Importance:Opioid overdose is the leading cause of injury-related death in the United States. Several studies have shown that surgeons overprescribe opioids, and guidelines for appropriate opioid prescribing are available. Concern about patient-reported satisfaction scores may be a barrier to surgeons adopting guidelin...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2019.2875
更新日期:2019-11-01 00:00:00
abstract:Importance:To our knowledge, thyroid cancer incidence is increasing faster than any other cancer type and is currently the fifth most common cancer among women. While this rise is likely multifactorial, there has been scarce consideration of the effect of insurance statuses on the treatment of thyroid cancer. Objectiv...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2017.0461
更新日期:2017-08-01 00:00:00
abstract:Importance:Surgery represents the mainstay treatment of colorectal liver metastases. Indications for the laparoscopic approach in this setting have been widened and there is a need to confirm the benefits of minimally invasive liver surgery (MILS) in patients with complex disease states. Objective:To compare outcomes ...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2018.2107
更新日期:2018-11-01 00:00:00
abstract:Importance:Hospitals are rapidly consolidating into regional delivery networks. To our knowledge, whether these multihospital networks leverage their combined assets to improve quality and provide a uniform standard of care has not been explored. Objective:To evaluate the extent to which surgical outcomes varied acros...
journal_title:JAMA surgery
pub_type: 杂志文章,多中心研究
doi:10.1001/jamasurg.2019.0090
更新日期:2019-06-01 00:00:00
abstract:IMPORTANCE:The Centers for Medicare and Medicaid Services have implemented penalties for hospitals with above-average readmission rates under the Hospital Readmissions Reductions Program. These changes will likely be extended to affect postoperative readmissions in the future. OBJECTIVES:To identify variables that pla...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2014.4043
更新日期:2015-06-01 00:00:00
abstract:Importance:Expansion of donor acceptance criteria for liver transplant increased the risk for early allograft failure (EAF), and although EAF prediction is pivotal to optimize transplant outcomes, there is no consensus on specific EAF indicators or timing to evaluate EAF. Recently, the Liver Graft Assessment Following ...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2020.4095
更新日期:2020-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the performance of 3-dimensional (3D) virtual neck exploration (VNE) as a modality for preoperative localization of parathyroid adenomas in primary hyperparathyroidism and assess the feasibility of using augmented reality to guide parathyroidectomy as a step toward minimally invasive imageguided s...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2013.739
更新日期:2013-03-01 00:00:00
abstract:Importance:The United States is experiencing an opioid abuse epidemic. Opioid overprescription by physicians may contribute to this epidemic. Objectives:To determine if there was a correlation between a postoperative patient's 24-hour predischarge opioid use and the amount of opioids prescribed at hospital discharge a...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2017.4859
更新日期:2018-02-21 00:00:00
abstract:UNLABELLED:IMPORTANCE It is not known whether hospital and surgeon volumes have an association with readmission among patients undergoing pancreatoduodenectomy. OBJECTIVE:To evaluate patient-, surgeon-, and hospital-level factors associated with readmission. DESIGN, SETTING, AND PARTICIPANTS:Retrospective cohort stud...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2013.2509
更新日期:2013-12-01 00:00:00
abstract:Importance:Medically treated symptomatic severe aortic stenosis has poor outcomes, and in the past 6 decades, it has successfully been treated with surgical aortic valve replacement (SAVR). However, one-third of patients with indications for SAVR are not offered surgery because of the high risk of complications. Transc...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2019.4449
更新日期:2019-11-27 00:00:00
abstract::Over the past decade, minimally invasive surgery has been introduced as a means to allow manipulation of delicate tissues with outstanding visualization of the surgical field. The purpose of this article is to review the available literature regarding early postoperative outcomes and the technical challenges of minima...
journal_title:JAMA surgery
pub_type: 杂志文章,评审
doi:10.1001/jamasurg.2013.366
更新日期:2013-12-01 00:00:00
abstract:IMPORTANCE:Damage control (DC) with intra-abdominal packing and delayed reconstruction is an accepted strategy in trauma and acute care surgery but has not been evaluated in liver transplant. OBJECTIVE:To evaluate the incidence, effect on survival, and predictors of the need for DC using intra-abdominal packing and de...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2015.1853
更新日期:2015-11-01 00:00:00
abstract:Importance:Adhesive small-bowel obstruction (aSBO) is a potentially chronic, recurring surgical illness. Although guidelines suggest trials of nonoperative management, the long-term association of this approach with recurrence is poorly understood. Objective:To compare the incidence of recurrence of aSBO in patients u...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2018.5248
更新日期:2019-05-01 00:00:00
abstract:IMPORTANCE:Older adults are at increased risk for adverse events after surgical procedures. Loss of independence (LOI), defined as a decline in function or mobility, increased care needs at home, or discharge to a nonhome destination, is an important patient-centered outcome measure. OBJECTIVE:To evaluate LOI among ol...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2016.1689
更新日期:2016-09-21 00:00:00
abstract:IMPORTANCE:Surgical site infection remains a major challenge in surgery. Delayed primary closure of dirty wounds is widely practiced in war surgery; we present a meta-analysis of evidence to help guide application of the technique in wider context. OBJECTIVE:To determine using meta-analysis whether delayed primary ski...
journal_title:JAMA surgery
pub_type: 杂志文章,meta分析,评审
doi:10.1001/jamasurg.2013.2336
更新日期:2013-08-01 00:00:00
abstract:IMPORTANCE:Endovascular technology has become ubiquitous in the modern care of abdominal aortic aneurysm (AAA), yet broad estimates of its efficacy among variable hospital and regional settings is not known. OBJECTIVE:To perform a preliminary analysis of hospital effects on mortality following open AAA repair (OAR) an...
journal_title:JAMA surgery
pub_type: 杂志文章,多中心研究
doi:10.1001/jamasurg.2014.3871
更新日期:2015-07-01 00:00:00
abstract:Importance:Surgical and medical device manufacturers have a cooperative relationship with clinicians. When evaluating published works, one should assess the integrity and academic credentials of the authors, who serve as putative experts. A relationship with a relevant manufacturer may increase the potential risk for b...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2018.2576
更新日期:2018-11-01 00:00:00
abstract:Importance:Living kidney donation is associated with increased long-term risk of end-stage renal disease (ESRD). An early postdonation marker of ESRD risk could improve postdonation risk assessment and counseling for kidney donors and allow early intervention for donors at increased risk. Objective:To determine the as...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2019.5472
更新日期:2020-03-01 00:00:00
abstract:IMPORTANCE:Although the diagnostic evaluation and technical elements for a successful laparoscopic fundoplication have been clearly identified, 10% to 20% of patients will eventually experience recurrence of their symptoms. The management of patients who fail antireflux surgery is complex and not well codified. OBJECT...
journal_title:JAMA surgery
pub_type: 杂志文章,评审
doi:10.1001/jamasurg.2014.3859
更新日期:2015-06-01 00:00:00
abstract:Importance:Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an innovative procedure in the treatment of noncompressible truncal hemorrhage. However, readily available fluoroscopy remains a limiting factor in its widespread implementation. Several methods have been proposed to perform REBOA without f...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2016.4757
更新日期:2017-04-01 00:00:00
abstract:Importance:The need for trainee sex equality within surgical training has resulted in an appraisal of the training experience in the New Zealand general surgery training program. Objective:To investigate the association between trainee sex and surgical autonomy in the operating room in the New Zealand general surgery ...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2020.3021
更新日期:2020-11-01 00:00:00
abstract:IMPORTANCE:The appropriately coached implementation of surgical safety checklists (SSCs) reduces the incidence of perioperative complications and 30-day mortality of patients undergoing surgery. The association of the introduction of SSCs with 90-day mortality remains unclear. OBJECTIVE:To assess the association betwe...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2015.5490
更新日期:2016-07-01 00:00:00
abstract:IMPORTANCE:Morphometric assessment has emerged as a strong predictor of postoperative morbidity and mortality. However, a gap exists in translating this knowledge to bedside decision making. We introduced a novel measure of patient-centered surgical risk assessment: morphometric age. OBJECTIVE:To investigate the relat...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2013.4823
更新日期:2014-04-01 00:00:00
abstract:Importance:Surgical site infection (SSI) rates are increasingly used as a quality metric. However, risk factors for SSI in pancreatic surgery remain undefined. Objective:To stratify superficial and organ-space SSIs after pancreatectomy and investigate their modifiable risk factors. Design, Setting, and Participants:T...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2017.2155
更新日期:2017-11-01 00:00:00
abstract:Importance:Minimally invasive laparoscopic surgery (MILS) for endometrial cancer reduces surgical morbidity compared with a total abdominal hysterectomy. However, only a minority of women with early-stage endometrial cancer undergo MILS. Objective:To evaluate the association between the Danish nationwide introduction ...
journal_title:JAMA surgery
pub_type: 杂志文章,多中心研究
doi:10.1001/jamasurg.2018.5840
更新日期:2019-06-01 00:00:00
abstract:IMPORTANCE:In an era of accountable care, understanding variation in health care costs is critical to reducing health care spending. OBJECTIVE:To identify factors associated with increased hospital costs and quantify variations in costs among individual hospitals in patients undergoing liver and pancreatic surgery in ...
journal_title:JAMA surgery
pub_type: 杂志文章
doi:10.1001/jamasurg.2015.3618
更新日期:2016-02-01 00:00:00