Trauma Activation Touchpoints as an Opportunity to Detect Undiagnosed Comorbidities in Vulnerable Populations.
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| Titel: | Trauma Activation Touchpoints as an Opportunity to Detect Undiagnosed Comorbidities in Vulnerable Populations. |
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| Autoren: | Banks KC; Department of Surgery, University of California San Francisco-East Bay, Oakland, California., Gochi AM; Department of Surgery, University of California San Francisco-East Bay, Oakland, California. Electronic address: andrea.gochi@ucsf.edu., Alcasid NJ; Department of Surgery, University of California San Francisco-East Bay, Oakland, California., Susai CJ; Department of Surgery, University of California San Francisco-East Bay, Oakland, California., Victorino KC; Department of Surgery, University of California San Francisco-East Bay, Oakland, California., Mendoza AE; Department of Surgery, University of California San Francisco-East Bay, Oakland, California., Victorino GP; Department of Surgery, University of California San Francisco-East Bay, Oakland, California. |
| Quelle: | The Journal of emergency medicine [J Emerg Med] 2025 Dec; Vol. 79, pp. 492-501. Date of Electronic Publication: 2025 Sep 09. |
| Publikationsart: | Journal Article |
| Sprache: | English |
| Info zur Zeitschrift: | Publisher: Elsevier Country of Publication: United States NLM ID: 8412174 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 0736-4679 (Print) Linking ISSN: 07364679 NLM ISO Abbreviation: J Emerg Med Subsets: MEDLINE |
| Imprint Name(s): | Publication: <2010>- : New York : Elsevier Original Publication: New York : Pergamon Press, c1983- |
| MeSH-Schlagworte: | Comorbidity* , Vulnerable Populations*/statistics & numerical data , Wounds and Injuries*/epidemiology , Wounds and Injuries*/complications, Humans ; Male ; Female ; Middle Aged ; Adult ; Aged ; Trauma Centers/organization & administration ; Trauma Centers/statistics & numerical data ; Hypertension/epidemiology ; Hypertension/diagnosis ; Cohort Studies ; Retrospective Studies |
| Abstract: | Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. Background: Many trauma patients have undiagnosed comorbidities. We hypothesized that among nonprivately insured patients, those with undiagnosed comorbidities have quantifiable metrics at the time of trauma activation (TA) associated with such diagnoses. Objectives: 1) To identify quantifiable metrics at TA that indicate the presence of undiagnosed comorbidities. 2) To evaluate the relationship between early clinical indicators at TA and the likelihood of receiving a new diagnosis within one year. Methods: We reviewed the first 250 patients at our level 1 trauma center in 2021 and collected blood pressures, glucose levels, other laborator tests, primary care physician (PCP) appointments, and diagnoses in the year after TA. National guidelines were used to define hypertension and hyperglycemia. Associations between patient characteristics and new diagnoses in the year after TA were identified. Secondary outcomes included new diagnoses of substance use disorder, Human Immunodeficiency Virus (HIV), and hepatitis C within 1 year of TA. Results: In this cohort of 250 patients, 75.0% were male and median age of 44 (29-68) years. Of the 178 patients without prior diagnosis of hypertension, 84 (47.2%) exhibited hospitalized blood pressures meeting stage 1 hypertension criteria and 45 (25.3%) exhibited hospitalized blood pressures meeting stage 2 hypertension criteria. Of the 220 patients without prior diagnosis of diabetes, 18 (8.2%) exhibited hospitalized glucose levels consistent with hyperglycemia. PCP follow-up after TA and hospitalized blood pressure meeting stage 2 hypertension criteria were independently associated with a new hypertension diagnosis. PCP follow-up after TA and hospitalized hyperglycemia were independently associated with a new diabetes diagnosis. Secondary outcomes included 19 new diagnoses of substance use disorder, 1 new HIV diagnosis, and 7 new hepatitis C diagnoses. Conclusion: Trauma and emergency providers can identify potential comorbid conditions and proactively integrate patients' trauma care into longitudinal healthcare. (Copyright © 2025 Elsevier Inc. All rights reserved.) |
| Contributed Indexing: | Keywords: comorbidity diagnosis; referral; screening; touchpoint; trauma activation |
| Entry Date(s): | Date Created: 20251109 Date Completed: 20251201 Latest Revision: 20251201 |
| Update Code: | 20251202 |
| DOI: | 10.1016/j.jemermed.2025.09.012 |
| PMID: | 41207112 |
| Datenbank: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstract: | Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.<br />Background: Many trauma patients have undiagnosed comorbidities. We hypothesized that among nonprivately insured patients, those with undiagnosed comorbidities have quantifiable metrics at the time of trauma activation (TA) associated with such diagnoses.<br />Objectives: 1) To identify quantifiable metrics at TA that indicate the presence of undiagnosed comorbidities. 2) To evaluate the relationship between early clinical indicators at TA and the likelihood of receiving a new diagnosis within one year.<br />Methods: We reviewed the first 250 patients at our level 1 trauma center in 2021 and collected blood pressures, glucose levels, other laborator tests, primary care physician (PCP) appointments, and diagnoses in the year after TA. National guidelines were used to define hypertension and hyperglycemia. Associations between patient characteristics and new diagnoses in the year after TA were identified. Secondary outcomes included new diagnoses of substance use disorder, Human Immunodeficiency Virus (HIV), and hepatitis C within 1 year of TA.<br />Results: In this cohort of 250 patients, 75.0% were male and median age of 44 (29-68) years. Of the 178 patients without prior diagnosis of hypertension, 84 (47.2%) exhibited hospitalized blood pressures meeting stage 1 hypertension criteria and 45 (25.3%) exhibited hospitalized blood pressures meeting stage 2 hypertension criteria. Of the 220 patients without prior diagnosis of diabetes, 18 (8.2%) exhibited hospitalized glucose levels consistent with hyperglycemia. PCP follow-up after TA and hospitalized blood pressure meeting stage 2 hypertension criteria were independently associated with a new hypertension diagnosis. PCP follow-up after TA and hospitalized hyperglycemia were independently associated with a new diabetes diagnosis. Secondary outcomes included 19 new diagnoses of substance use disorder, 1 new HIV diagnosis, and 7 new hepatitis C diagnoses.<br />Conclusion: Trauma and emergency providers can identify potential comorbid conditions and proactively integrate patients' trauma care into longitudinal healthcare.<br /> (Copyright © 2025 Elsevier Inc. All rights reserved.) |
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| ISSN: | 0736-4679 |
| DOI: | 10.1016/j.jemermed.2025.09.012 |