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Cues to care: Chronic disease diagnosis in young adult trauma patients.

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Adams, U; Portelli Tremont, J; Yohann, A; Aldridge, J; Riggins, S; Brownstein, M; Charles, A; Udekwu, PO ...
Published in: J Trauma Acute Care Surg
January 1, 2024

BACKGROUND: Prevention of chronic disease necessitates early diagnosis and intervention. In young adults, a trauma admission may be an early contact with the health care system, representing an opportunity for screening and intervention. This study estimates the prevalence of previously diagnosed disease and undiagnosed disease (UD)-diabetes mellitus, hypertension, obesity, and alcohol and substance use-in a young adult trauma population. We determine factors associated with UD and examine outcomes in patients with UD. METHODS: This is a multicenter, retrospective cohort study of adult trauma patients 18 to 40 years old admitted to participating Level I trauma centers between January 2018 and December 2020. Three Level 1 trauma centers in a single state participated in the study. Trauma registry data and chart review were examined for evidence of previously diagnosed disease or UD. Patient demographics and outcomes were compared between cohorts. Multivariable regression modeling was performed to assess risk factors associated with any UD. RESULTS: The analysis included 6,307 admitted patients. Of these, 4,843 (76.8%) had evidence of at least 1 UD, most commonly hypertension and obesity. In multivariable models, factors most associated with risk of UD were age (adjusted odds ratio [aOR], 0.98; 95% confidence interval [CI], 0.98-0.99), male sex (aOR, 1.43; 95% CI, 1.25-1.63), and uninsured status (aOR, 1.57; 95% CI, 1.38-1.80). Only 24.5% of patients had evidence of a primary care provider (PCP), which was not associated with decreased odds of UD. Clinical outcomes were significantly associated with the presence of chronic disease. Of those with UD and no PCP, only 11.2% were given a referral at discharge. CONCLUSION: In the young adult trauma population, the UD burden is high, especially among patients with traditional sociodemographic risk factors and even in patients with a PCP. Because of short hospital stays in this population, the full impact of UD may not be visible during a trauma admission. Early chronic disease diagnosis in this population will require rigorous, standard screening measures initiated within trauma centers. LEVEL OF EVIDENCE: Prognostic and Epidemiological; Level IV.

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Published In

J Trauma Acute Care Surg

DOI

EISSN

2163-0763

Publication Date

January 1, 2024

Volume

96

Issue

1

Start / End Page

70 / 75

Location

United States

Related Subject Headings

  • Young Adult
  • Retrospective Studies
  • Obesity
  • Male
  • Hypertension
  • Humans
  • Emergency & Critical Care Medicine
  • Diabetes Mellitus
  • Cues
  • Chronic Disease
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Adams, U., Portelli Tremont, J., Yohann, A., Aldridge, J., Riggins, S., Brownstein, M., … Prevention in Young Adult Trauma Patients Multicenter Study Group, . (2024). Cues to care: Chronic disease diagnosis in young adult trauma patients. In J Trauma Acute Care Surg (Vol. 96, pp. 70–75). United States. https://doi.org/10.1097/TA.0000000000004149
Adams, Ursula, Jaclyn Portelli Tremont, Avital Yohann, Joshua Aldridge, Stephanie Riggins, Michelle Brownstein, Anthony Charles, Pascal Osita Udekwu, and Pascal Osita Prevention in Young Adult Trauma Patients Multicenter Study Group. “Cues to care: Chronic disease diagnosis in young adult trauma patients.” In J Trauma Acute Care Surg, 96:70–75, 2024. https://doi.org/10.1097/TA.0000000000004149.
Adams U, Portelli Tremont J, Yohann A, Aldridge J, Riggins S, Brownstein M, et al. Cues to care: Chronic disease diagnosis in young adult trauma patients. In: J Trauma Acute Care Surg. 2024. p. 70–5.
Adams, Ursula, et al. “Cues to care: Chronic disease diagnosis in young adult trauma patients.J Trauma Acute Care Surg, vol. 96, no. 1, 2024, pp. 70–75. Pubmed, doi:10.1097/TA.0000000000004149.
Adams U, Portelli Tremont J, Yohann A, Aldridge J, Riggins S, Brownstein M, Charles A, Udekwu PO, Prevention in Young Adult Trauma Patients Multicenter Study Group. Cues to care: Chronic disease diagnosis in young adult trauma patients. J Trauma Acute Care Surg. 2024. p. 70–75.

Published In

J Trauma Acute Care Surg

DOI

EISSN

2163-0763

Publication Date

January 1, 2024

Volume

96

Issue

1

Start / End Page

70 / 75

Location

United States

Related Subject Headings

  • Young Adult
  • Retrospective Studies
  • Obesity
  • Male
  • Hypertension
  • Humans
  • Emergency & Critical Care Medicine
  • Diabetes Mellitus
  • Cues
  • Chronic Disease