The association between the outcomes of trauma, education and some socio-economic indicators

Document Type : Original Article

Authors

1 Sina Trauma and Surgery Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran

2 Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran

3 Trauma Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

4 Patient safety research center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran

5 Clinical Research Development Center, Imam Ali and Taleghani Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran

6 Clinical Research Development Unit, Imam Hossein Hospital, Shahroud University of Medical Sciences, Shahroud, Iran

7 Department of Emergency Medicine, Faculty of Medicine, Isfahan University of Medical Sciences, Trauma Data Registration Center, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: There are many debates on socioeconomic indicators influencing trauma outcomes.
Objectives: This study aimed to determine the association between education as a socioeconomic indicator and trauma outcomes.
Methods: This descriptive-analytical study was conducted on 30,448 trauma patients during 2016-2021. The data were based on the minimum dataset of the National Trauma Registry of Iran (NTRI) from six different trauma centers in various cities of the country. The variables used in this study included age, education level, marital status, cause of injury, Glasgow Coma Scale (GCS), intensive care unit (ICU) admission, Injury Severity Score (ISS), and in-hospital mortality. Logistic regression was used to investigate the association between independent variables and trauma outcomes.
Results: The study included 30,448 trauma patients with male predominance (75.8%). The mean age was 36.9 years. The most frequent education level was secondary education, with 14,228 (46.6%). Education levels had significant relationships with ISS, death, and ICU admission (P<0.001). Moreover, after applying the multiple logistic regression, the odds of deaths for trauma patients with no formal, primary, and secondary education levels were 3.36, 5.03, and 3.65 times, respectively, more than the odds of deaths at the higher education level after controlling for other factors (all Ps<0.05). However, there were no such relationships between education levels and the odds of ICU admission.
Conclusion: Findings of the present study showed a significant association between the education levels and trauma outcomes. Adjusted for other covariates, the chance of death for trauma patients with no formal, primary, or secondary education levels was higher than that at the higher education level.

Highlights

Payman Salamati [Pubmed] [Google Scholar]

 

Keywords

References

  1. Alberdi F, García I, Atutxa L, Zabarte M. Epidemiology of severe trauma. Medicina Intensiva. 2014;38(9):580-8. doi:10.1016/j.medin.2014.06.012
  2. Imam MA, Torieh A, Matthana A. Double plating of intra-articular multifragmentary C3-type distal femoral fractures through the anterior approach. Eur J Orthop Surg Traumatol. 2018;28(1):121-30. doi:10.1007/s00590-017-2014-9
  3. Mohammad Haji Aghajani, Mashyaneh Haddadi, and Soheil Saadat. Epidemiological Pattern of Injuries in Iran; a Nationwide Review of Seven Million Emergency Department Admissions. Emergency. 2017; 5(1): e10.
  4. Vos T, Lim SS, Abbafati C, Abbas KM, Abbasi M, Abbasifard M, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020;396(10258):1204-22. doi:10.1016/S0140-6736(20)30925-9
  5. World Health Organization. World Health Statistics; 2009. Available from: http://int/whosis/whostat.EN_WHS09_Table 6pdf. [Last access date 12 Dec 2009].
  6. Abedzadeh-Kalahroudi M, Razi E, Sehat M. The relationship between socioeconomic status and trauma outcomes. J Public Health. 2018; 40 (4): e431-e9. doi:10.1093/pubmed/fdy033
  7. World Health Organization. The global burden of disease: 2004 update: World Health Organization; 2008.
  8. Langlois JA, Rutland-Brown W, Wald MM. The epidemiology and impact of traumatic brain injury: a brief overview. J Head Trauma Rehabil. 2006;21(5):375-8. doi:10.1097/00001199-200609000-00001
  9. Zargar M, Motamedi SMRK, Karbakhsh M, Ghodsi SM, Rahimi-Movaghar V, Panahi F, et al. Trauma care system in Iran. Chin J Traumatol (English Edition). 2011;14(3):131-6.
  10. Khatibi SR, Dinpanah H, Maajani K, Khodadost M. The burden of road traffic injuries in the northeast of Iran: the result of a population-based registry. J Inj Violence Res. 2020;12(1):63. doi:10.5249/jivr.v12i1.1265
  11. Available from: https://lmo.ir/web_directory/53999‑%D8%AA%D8%B5%D8%A7%D8%AF%D9%81%D8%A7%D8%AA.html. [Last access date 1 May 2023].
  12. Sanchez C, Shaikh S, Dowd B, Santos R, McKenney M, Elkbuli A. Disparities in Adult and Pediatric Trauma Outcomes: A Systematic Review and Meta-Analysis. World J Surg. 2020; 44:3010-21. doi:10.1007/s00268-020-05591-2
  13. Carley S, Driscoll P. Trauma education. Resuscitation. 2001;48(1):47-56. doi:10.1016/S0300-9572(00)00317-8
  14. World Health Organization 2020. Regional Office for Europe: Health and sustainable development: achieving Sustainable Development Goal 3 on health and well-being and other health related SDG targets in Turkmenistan. PROGRESS REPORT 2020. Available from: https://apps.who.int/iris/bitstream/handle/10665/338442/WHO-EURO-2020-1802-41553-56703-eng.pdf?sequence=1&isAllowed=y. [Last accessed on 2023 May 1].
  15. Erika González García, Andrea Cívico Ariza, Ernesto Colomo Magaña. Quality Education as a Sustainable Development Goal in the Context of 2030 Agenda: Bibliometric Approach. Sustainability. 2020, 12(15), 5884 doi:10.3390/su12155884
  16. Heydari S, Hoseinzadeh A, Ghaffarpasand F, Hedjazi A, Zarenezhad M, Moafian G, et al. Epidemiological characteristics of fatal traffic accidents in Fars province, Iran: a community-based survey. Public Health. 2013;127(8):704-9. doi:10.1016/j.puhe.2013.05.003
  17. Lankarani KB, Sarikhani Y, Heydari ST, Joulaie H, Maharlouei N, Peimani P, et al. Traffic accidents in Iran, a decade of progress but still challenges ahead. Med J Islam Rep Iran. 2014; 28:96.
  18. Reshadat S, Zangeneh A, Saeidi S, Teimouri R, Yigitcanlar T. Measures of spatial accessibility to health centers: investigating urban and rural disparities in Kermanshah, Iran. J Public Health. 2019;27(4):519-29. doi:10.1007/s10389-018-0966-9
  19. Sharif-Alhoseini M, Zafarghandi M, Rahimi-Movaghar V, Heidari Z, Naghdi K, Bahrami S, et al. National Trauma Registry of Iran: a pilot phase at a major trauma center in Tehran. Arch Iran Med. 2019; 22 (6): 286-92.
  20. Haines KL, Zens T, Beems M, Rauh R, Jung HS, Agarwal S. Socioeconomic disparities in the thoracic trauma population. J Surg Res. 2018; 224:160-5. doi:10.1016/j.jss.2017.11.071
  21. Haines KL, Agarwal S, Jung HS. Socioeconomics affecting quality outcomes in Asian trauma patients within the United States. J Surg Res. 2018; 228:63-7.21. doi:10.1016/j.jss.2018.02.060
  22. Hoyt DB, Coimbra R, Fortlage D, Holbrook T, Hollingsworth-Fridlund P, et al. (2004). The epidemiology of serious and fatal injury in San Diego County over an 11-year period. J Trauma. 56(1):68-75. doi:10.1097/01.TA.0000101490.32972.9F
  23. World Health Organization. Injuries in Europe: A call for Public Health Action, an Update Using the 2011 WHO Global Health Estimates; 2011. Available from: www.euro.who.int/__/Injuries‑in‑WHO‑European‑Region‑A‑call‑for‑public‑health‑. [Last access date, 28Mar 2018].
  24. Padovani C, Da Silva JM, Peruzzo Rotta B, Pires Neto RC, FuC, Tanaka C. Recovery of functional capacity in severe trauma victims at one year after injury: association with trauma-related and hospital stay aspects. J Phys Ther Sci. 2016;28(5):1432-1437. doi:10.1589/jpts.28.1432
  25. Modaghegh MHS, Saremi E, Mohamadian M, Jafarzadeh R. Characteristics of trauma in north east Iran and the prevention strategies. Arch Iran Med. 2013;16(10): 576 - 579.
  26. Tamim H, Al Hazzouri AZ, Mahfoud Z, Atoui M, El-Chemaly S. The injury severity score or the new injury severity score for predicting mortality, intensive care unit admission and length of hospital stay: experience from a university hospital in a developing country. Injury. 2008; 39(1):115-20. doi:10.1016/j.injury.2007.06.007
  27. Kalahroudi M, Razi E, Sehat M, Asadi Lari M. Measurement of disability and its predictors among trauma patients: a follow-up study. J Arch Trauma Res. 2015; 4(3): e29393. doi:10.5812/atr.29393
  28. Sheridan E, Wiseman JM, Malik AT, Pan X, Quatman CE, Santry HP, et al. The role of sociodemographics in the occurrence of orthopaedic trauma. Injury. 2019;50(7):1288-92. doi:10.1016/j.injury.2019.05.018
  29. Brattström O, Eriksson M, Larsson E, Oldner A. Socio-economic status and co-morbidity as risk factors for trauma. Eur J Epidemiol. 2015;30(2):151-7. doi:10.1007/s10654-014-9969-1
  30. Haider AH, Weygandt PL, Bentley JM, Monn MF, Rehman KA, Zarzaur BL, et al. Disparities in trauma care and outcomes in the United States: a systematic review and meta-analysis. J Trauma Acute Care Surg. 2013;74(5):1195. doi:10.1097/TA.0b013e31828c331d
  31. Udyavar R, Perez S, Haider A. Equal Access Is Quality: An Update on the State of Disparities Research in Trauma. Cur Trauma Rep. 2018;4(1):25-38. doi:10.1007/s40719-018-0114-6
  32. Herrera-Escobar JP, Seshadri AJ, Rivero R, Toppo A, Al Rafai SS, Scott JW, et al. Lower education and income predict worse long-term outcomes after injury. J Trauma Acute Care Surg. 2019;87(1):104-10. doi:10.1097/TA.0000000000002329  
Archives of Trauma Research
Volume 12, Issue 2
July 2023
Pages 84-89

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History

  • Receive Date: 12 December 2022
  • Revise Date: 10 January 2023
  • Accept Date: 10 January 2023

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