Olubode A Olufajo1, Zara Cooper2, Brian K Yorkgitis3, Peter A Najjar4, David Metcalfe4, Joaquim M Havens2, Reza Askari2, Gabriel A Brat3, Adil H Haider2, Ali Salim2. 1. Division of Trauma, Burn and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School and Harvard T.H. Chan School of Public Health, 1620 Tremont Street, Boston, MA 02121, USA. Electronic address: oao777@mail.harvard.edu. 2. Division of Trauma, Burn and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School and Harvard T.H. Chan School of Public Health, 1620 Tremont Street, Boston, MA 02121, USA. 3. Division of Trauma, Burn and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA. 4. Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School and Harvard T.H. Chan School of Public Health, 1620 Tremont Street, Boston, MA 02121, USA.
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.
BACKGROUND: There is a paucity of data on the causes and associated patient factors for unplanned readmissions among traumapatients. 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 traumapatients, with many readmitted at other hospitals. Targeted interventions among high-risk patients may reduce readmissions after traumatic injuries.
Authors: Lisa M Knowlton; Alex H S Harris; Lakshika Tennakoon; Mary T Hawn; David A Spain; Kristan L Staudenmayer Journal: J Trauma Acute Care Surg Date: 2019-03 Impact factor: 3.313
Authors: David Metcalfe; Cheryl K Zogg; Elliott R Haut; Timothy M Pawlik; Adil H Haider; Daniel C Perry Journal: Int J Epidemiol Date: 2019-12-01 Impact factor: 7.196
Authors: Lisa M Knowlton; Joseph Minei; Lakshika Tennakoon; Kimberly A Davis; Jay Doucet; Andrew Bernard; Adil Haider; L R Tres Scherer; David A Spain; Kristan L Staudenmayer Journal: J Trauma Acute Care Surg Date: 2019-04 Impact factor: 3.313
Authors: Elizabeth Y Killien; Roel L N Huijsmans; Monica S Vavilala; Anneliese M Schleyer; Ellen F Robinson; Rebecca G Maine; Frederick P Rivara Journal: J Surg Res Date: 2021-04-10 Impact factor: 2.417
Authors: Michelle C Woodfall; Timothy D Browder; Jesus M Alfaro; Meghan A Claudius; Garrett K Chan; Denise Greci Robinson; David A Spain Journal: Trauma Surg Acute Care Open Date: 2017-01-27