The truth about trauma readmissions

Abstract Background There is a paucity of data on the causes and associated patient factors for unplanned readmissions among trauma patients. Methods We examined patients admitted for traumatic injuries between 2007 and 2011 in the California State Inpatient Database. Using chi-square tests and mult...

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Bibliographic Details
Published in:The American journal of surgery 2016-04, Vol.211 (4), p.649-655
Main Authors: Olufajo, Olubode A., M.D., M.P.H, Cooper, Zara, M.D., M.Sc, Yorkgitis, Brian K., D.O, Najjar, Peter A., M.D, Metcalfe, David, L.L.B., M.B.Ch.B, Havens, Joaquim M., M.D, Askari, Reza, M.D, Brat, Gabriel A., M.D., M.Sc, Haider, Adil H., M.D., M.P.H, Salim, Ali, M.D
Format: Article
Language:English
Subjects:
Adolescent
Adult
Age
California
Clinical outcomes
Comorbidity
Confidence intervals
Databases, Factual
Ethnicity
Female
Hispanic people
Home health care
Hospitals
Humans
Injuries
Injury
Injury Severity Score
Male
Middle Aged
Mortality
Nursing
Patient admissions
Patient Readmission - statistics & numerical data
Readmission
Reason
Risk Factors
Studies
Surgery
Thorax
Trauma
Wounds and Injuries - therapy
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Summary:Abstract Background There is a paucity of data on the causes and associated patient factors for unplanned readmissions among trauma patients. Methods We examined patients admitted for traumatic injuries between 2007 and 2011 in the California State Inpatient Database. Using chi-square tests and multivariate logistic regression models, we determined rates, reasons, locations, and patient factors associated with 30-day readmissions. Results Among 252,752 trauma discharges, the overall readmission rate was 7.56%, with 36% of readmissions occurring at a hospital different from the hospital of initial admission. Predictors of readmissions included being discharged against medical advice (odds ratio [OR]: 2.56 [2.35 to 2.76]); Charlson scores ≥2 (OR: 2.00 [1.91 to 2.10]); and age ≥45 years (OR: 1.29 [1.25 to 1.33]). Major reasons for readmissions were musculoskeletal complaints (22.29%), psychiatric conditions (9.40%), and surgical infections (6.69%). Conclusions Health and social vulnerabilities influence readmission among trauma patients, with many readmitted at other hospitals. Targeted interventions among high-risk patients may reduce readmissions after traumatic injuries.
ISSN:0002-9610
1879-1883
DOI:10.1016/j.amjsurg.2015.09.018