A year’s trauma admissions and the effect of the weather
Introduction
One of the major problems encountered in the provision of trauma services is in trying to allow for the variability of admission numbers. One factor commonly perceived to be important is the weather on the day of admission. We decided to investigate the presence and nature of any such link.
The Leicester Royal Infirmary is one of the busiest trauma units in the country—serving a catchment population of 1.1 million, served by a single Accident & Emergency Department (A&E) with visits at around 110,000 per year, and around 3000 admissions to acute trauma beds per annum.
Section snippets
Method
Trauma admission data was collected for the period 1 January 1998–31 December 1998. These were analysed on a day-to-day basis. Only admissions to Inpatient beds were examined. Admissions with diagnoses other than definite trauma, such as infections, non-traumatic back pain, ‘irritable hips’, etc. were not included. Admissions were either via the Accident & Emergency Department or via the general practitioner (GP)—planned admissions via Fracture Clinic (and therefore ‘non-acute’) were also
Statistical analysis
Using Poisson regression analysis, various factors were explored for their potential importance in explaining day-to-day variation in admission rates for (a) total; (b) adult total; (c) adult neck of femur; and (d) paediatric orthopaedic trauma admissions. A multivariate model for each of the four outcomes was developed using a forward stepwise model selection procedure with a 5% statistical significance entry criteria.
In order to assess whether there was evidence of serial correlation in the
Results
A total of 2914 patients were admitted during the study period, 2279 adults and 635 children. Of those adults, 693 were with a diagnosis of fractured neck of femur (NOF). Thus, an ‘average’ day’s admissions approximate to eight, of whom six were adults and two children. Of the six adults, two would have a fractured NOF.
The mean daily admissions were 7.98. The range was widespread, from several days with no admissions at all, to a maximum of 22.
Initially, data was plotted on simple cumulative
Discussion
We have analysed admission data to a busy trauma unit on a day-to-day basis over a period of 1 year. Two thousand nine hundred and fourteen (2914) patients were identified for the database. The effects of a variety of weather and temporal factors were examined and various correlations found.
The total admission numbers rose over the summer months—this trend was largely explained by a corresponding rise in paediatric admissions. Increased daily temperatures, more hours of sunshine and fewer
Conclusion
Trauma admissions are related to both weather and temporal factors. Weather factors appear particularly important for paediatric trauma admissions. Adult (and more specifically fractured neck of femur) admissions appear to be related to days of the week.
These findings may have implications both in terms of prevention and in planning of care provision in trauma units.
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