Zhamak Khorgami1, Kaily L Ewing2, Nasir Mushtaq3, Geoffrey S Chow4, C Anthony Howard5. 1. Department of Surgery, The University of Oklahoma, College of Medicine, Tulsa, OK, USA. Electronic address: Zhamak-Khorgami@ouhsc.edu. 2. Department of Surgery, The University of Oklahoma, College of Medicine, Tulsa, OK, USA. Electronic address: Kaily-Ewing@ouhsc.edu. 3. Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Tulsa, OK, USA. Electronic address: Nasir-Mushtaq@ouhsc.edu. 4. Department of Surgery, The University of Oklahoma, College of Medicine, Tulsa, OK, USA. Electronic address: Geoffrey-Chow@ouhsc.edu. 5. Department of Surgery, The University of Oklahoma, College of Medicine, Tulsa, OK, USA. Electronic address: tony-howard@ouhsc.edu.
Abstract
BACKGROUND: The ability to predict the need for discharge of trauma patients to a facility may help shorten hospital stay. This study aimed to determine the predictors of discharge to a facility and develop and validate a predictive scoring model, utilizing the Oklahoma Trauma Registry (OTR). METHODS: A multivariate analysis of the OTR 2005-2013 determined independent predictors of discharge to a facility. A scoring model was developed, and positive and negative predictive values (PPV and NPV) were evaluated for 2014 patients. RESULTS: 101,656 patients were analyzed. The scoring model included age≥50 years, lower extremity fracture, ICU stay≥5 days, pelvic fracture, intracranial hemorrhage, congestive heart failure, cardiac dysrhythmia, history of CVA or TIA, and ISS≥15, spine fracture, diabetes mellitus, hypertension, ischemic heart disease, and chronic obstructive pulmonary disease. Applying the model to 2014 patients, PPV for predicting discharge to a facility was 84.9% for scores≥15, and NPV was 90.5% for scores<8. CONCLUSION: A scoring model including age, trauma severity, types of injury, and comorbidities could predict discharge of trauma patients to a facility. Further studies are needed to refine the efficacy of the model.
BACKGROUND: The ability to predict the need for discharge of traumapatients to a facility may help shorten hospital stay. This study aimed to determine the predictors of discharge to a facility and develop and validate a predictive scoring model, utilizing the Oklahoma Trauma Registry (OTR). METHODS: A multivariate analysis of the OTR 2005-2013 determined independent predictors of discharge to a facility. A scoring model was developed, and positive and negative predictive values (PPV and NPV) were evaluated for 2014 patients. RESULTS: 101,656 patients were analyzed. The scoring model included age≥50 years, lower extremity fracture, ICU stay≥5 days, pelvic fracture, intracranial hemorrhage, congestive heart failure, cardiac dysrhythmia, history of CVA or TIA, and ISS≥15, spine fracture, diabetes mellitus, hypertension, ischemic heart disease, and chronic obstructive pulmonary disease. Applying the model to 2014 patients, PPV for predicting discharge to a facility was 84.9% for scores≥15, and NPV was 90.5% for scores<8. CONCLUSION: A scoring model including age, trauma severity, types of injury, and comorbidities could predict discharge of traumapatients to a facility. Further studies are needed to refine the efficacy of the model.
Authors: Alisha Lussiez; John R Montgomery; Naveen F Sangji; Zhaohui Fan; Bryant W Oliphant; Mark R Hemmila; Justin B Dimick; John W Scott Journal: J Trauma Acute Care Surg Date: 2021-08-01 Impact factor: 3.697