Assessing Futile Trauma Transfers in Rural Appalachia Following a Regional Health Care System Consolidation

• Published in: The American surgeon 2024-07, Vol.90 (7), p.1922-1924
• Main Authors: Everly, Michelle A., Archer, Allen, Heard, Matt, Roche, Keelin, Burns, J. Bracken
• Format: Article
• Language: English
• Subjects: Adult; Aged; Appalachian Region; Female; Humans; Male; Medical Futility; Middle Aged; Patient Transfer - statistics & numerical data; Registries; Retrospective Studies; Rural Population - statistics & numerical data; Trauma Centers; Wounds and Injuries - mortality; Wounds and Injuries - therapy
• ISSN: 0003-1348; 1555-9823
• DOI: 10.1177/00031348241241719

This study sought to define and analyze rates of futile trauma transfers (FTTs) after the consolidation of two rural level 1 trauma centers into one. Data was extracted from the regional trauma registry for a period of 5 years (2017-2022) for all trauma patients transferred into our level 1 trauma center (n = 3369). An FTT was defined as a transfer that (1) received no major interventions and (2) died or was discharged to a hospice facility within 72 hours. Out of the 3369 transfer patients analyzed during the 33-month pre-consolidation and 33-month post-consolidation periods, 34 patients met the criteria of an FTT within the transfer-to-discharge window. The pre-consolidation category contained 12, and the post-consolidation category contained 22. Chi-square analysis indicated no significant difference in FTT rate between categories. Furthermore, the post-consolidation FTT rate of 1.1% remained consistent with the estimated national average of 1.5%.