Rates, Patterns, and Determinants of Unplanned Readmission After Traumatic Injury

Moore, Lynne; Stelfox, Henry T.; Turgeon, Alexis F.; Nathens, Avery B.; Sage, Natalie Le; Émond, Marcel; Bourgeois, G; Lapointe, Jean; Gagné, Mathieu

doi:10.1097/sla.0b013e31828b0fae

Cited by 91 publications

(95 citation statements)

References 21 publications

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“…6 Finally, a recently published retrospective cohort study of 115,329 trauma patients in the Quebec trauma registry found a 5.9% unplanned 30-day readmission rate. 19 There was a significant rate of readmission within 12 months of 21.1%. They found that readmissions within 30 days in patients younger than 65 years old were as likely to be due to a new injury as to a complication from the original injury (30.8% and 31.6%); in patients 65 years or older, 33.2% were readmitted for complications of initial injury and 16.3% for a new injury.…”

Section: Commentmentioning

confidence: 97%

Early unplanned hospital readmission after acute traumatic injury: the experience at a state-designated level-I trauma center

Copertino

McCormack

Rutigliano

et al. 2015

The American Journal of Surgery

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Section: Commentmentioning

confidence: 97%

Early unplanned hospital readmission after acute traumatic injury: the experience at a state-designated level-I trauma center

Copertino

McCormack

Rutigliano

et al. 2015

The American Journal of Surgery

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“…There is a relationship between comorbidities and readmissions after orthopaedic trauma surgery [23,35]. In orthopaedic surgery, comorbidities have been identified as predictors of mortality after arthroplasty, trauma surgery, and oncologic surgery [4,9,18,20,21,25,27,36].…”

Section: Introductionmentioning

confidence: 99%

Higher Charlson Comorbidity Index Scores are Associated With Readmission After Orthopaedic Surgery

Voskuijl

Hageman

Ring

2014

Clinical Orthopaedics &Amp; Related Research

173

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Background The Charlson Comorbidity Index (CCI) originally was developed to predict mortality within 1 year of hospital admission in patients without trauma. As it includes factors associated with medical and surgical complexities, it also may be useful as a predictive tool for hospital readmission after orthopaedic surgery, but to our knowledge, this has not been studied. Questions/purposes We asked whether an increased score on the CCI was associated with (1) readmission, (2) an increased risk of surgical site infection or other adverse events, (3) transfusion risk, or (4) mortality after orthopaedic surgery. Methods A total of 30,129 orthopaedic surgeries performed between 2008 and 2011 without any orthopaedic surgery in the preceding 30 days were analyzed. International Classification of Diseases, 9 th Revision codes were used to identify diagnoses, procedures, surgery-related adverse events, surgical site infection, and comorbidities as listed in the updated and reweighted CCI. A total of 913 patients (3.0%) were readmitted within 30 days after discharge; in 393 (1.4%) patients adverse events occurred; 417 patients (1.4%) had a surgical site infection develop; 211 (0.7%) needed transfusions, and 56 (0.2%) died within 30 days after surgery. Ordinary least squares regression analyses were used to determine whether the CCI was associated with these outcomes. Results The CCI accounted for 10% of the variation in readmissions. Every point increase in CCI score added an additional 0.45% risk in readmission for patients undergoing arthroplasty, 0.63% for patients undergoing trauma surgery, and 0.9% risk for patients undergoing spine surgery (all p \ 0.01). The CCI was not associated with surgical site infection or other adverse events, but accounted for 8% of the variation in transfusion rate and 10% of the variation in mortality within 30 days of surgery. Conclusions The CCI can be used to estimate the risk of readmission after arthroplasty, hand and upper extremity surgery, spine surgery, and trauma surgery. It also can be used to estimate the risk of transfusion after arthroplasty, spine, trauma, and oncologic orthopaedic surgery and the risk of mortality after shoulder, trauma, and oncologic orthopaedic surgery.

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“…This study used competing risk regression and shows that patients with the high risk of readmission in year after injury were those who had falls/severe head injury/ index ICU admission. Previous studies shown that 30-day readmission rates after trauma range from 4.2% to 13.3% 17,18,26 . Spector and colleagues 17 focused on older adults, finding a 30-day readmission rate which was higher than current study (13.3% vs 7.9%) 17 .…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, earlier studies have depicted that readmissions occur at hospitals other than the index establishment 26 . The detail of the CHARS database also allowed exclusion of elective readmissions, hence targeting unplanned rehospitalisation.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors For Unplanned Readmission In Older Adult Trauma Patients In Our Institute

Pardeshi¹

2017

jmscr

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Objective-To determine the unplanned admissions after hospitalization for trauma and risk factors for this readmissions and identifying the most common cause for the same. Material and Methods-This retrospective cohort study includes all cohort patients ages 55 and above who got admitted in Krishna Institute of Medical Sciences, Karad between September 2014 to November 2016. Data is entered for all patients who have traumatic diagnosis ICD-9.Results-The ICD-9 diagnosis codes that were recorded for the readmissions in this study were compiled, and the 3 codes that were noted most commonly used were the same for all readmission end points; atrial fibrillation, anemia ("post-hemorrhagic" or "other/ unspecified"), and congestive heart failure ("acute on chronic" or "unspecified"). These diagnoses accounted for a mean of 13%, 13%, and 11% of readmission diagnoses, respectively. Conclusion-Our study shows post traumatic unplanned readmissions in older adult causes huge health care burden even after a year of discharge especially in patients who had history of falls, severe head trauma, admission in ICU or those who could not be discharged home independently.

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Rates, Patterns, and Determinants of Unplanned Readmission After Traumatic Injury

Cited by 91 publications

References 21 publications

Early unplanned hospital readmission after acute traumatic injury: the experience at a state-designated level-I trauma center

Early unplanned hospital readmission after acute traumatic injury: the experience at a state-designated level-I trauma center

Higher Charlson Comorbidity Index Scores are Associated With Readmission After Orthopaedic Surgery

Risk Factors For Unplanned Readmission In Older Adult Trauma Patients In Our Institute

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