Trauma patient readmissions

Petrey, Laura B.; Weddle, Rebecca Joanne; Richardson, Brian A.; Gilder, Richard E.; Reynolds, Megan; Cook, Alan; Foreman, Michael L.; Warren, Ann Marie

doi:10.1097/ta.0000000000000844

Cited by 39 publications

(19 citation statements)

References 26 publications

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“…The proportion of pediatric readmissions caused by infection (22.3%) exceeds that reported in the adult literature (1.5–14%). (12, 16, 32) This is not unexpected given that infection, most often respiratory, is the most frequent reason for hospitalization in childhood. (33) Additionally, the subset of children within our cohort who develop neurologic (such as seizures) or neuromuscular chronic conditions as a result of their trauma may be at higher risk of hospitalization and complications from respiratory infections due to impaired airway protective reflexes, restrictive lung disease due to ineffective chest expansion, chronic pulmonary injury due to microaspiration, or lung injury incurred during their injury or during mechanical ventilation post-injury.…”

Section: Discussionmentioning

confidence: 94%

“…(15–17) Higher injury severity, pre-injury comorbidities, and low socioeconomic status are associated with greater readmission risk in adults. (12, 15, 16, 18, 19) Adult and pediatric trauma differs in regard to mechanism, type of injury, and patient-specific factors. (12, 20, 21) Additionally, care networks and post-discharge resources differ significantly and are likely to influence readmission rates.…”

Section: Introductionmentioning

confidence: 99%

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Hospital Readmissions After Pediatric Trauma

Maddux

DeWitt

Mourani

et al. 2018

Pediatric Critical Care Medicine

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Hospital Readmissions After Pediatric Trauma

Maddux

DeWitt

Mourani

et al. 2018

Pediatric Critical Care Medicine

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“…Multiple studies looked at readmissions following traumatic injury in both the general population as well as in the elderly. 4 , 13 , 14 One such study found a readmission rate of 20.6% overall and 26.9% for falls. 14 Focusing only on elderly trauma patients, using statewide data for Washington State, Fawcett et al showed that patients who were 55 years of age and older who survived their initial hospitalization had a readmission rate of 7.9% at 30 days and 25.2% at 1 year.…”

Section: Introductionmentioning

confidence: 99%

“… 4 , 13 , 14 One such study found a readmission rate of 20.6% overall and 26.9% for falls. 14 Focusing only on elderly trauma patients, using statewide data for Washington State, Fawcett et al showed that patients who were 55 years of age and older who survived their initial hospitalization had a readmission rate of 7.9% at 30 days and 25.2% at 1 year. 13 Additionally, they showed that the strongest risk factors for readmission were an initial trauma that resulted in severe head injury and discharge to a skilled nursing facility (SNF).…”

Section: Introductionmentioning

confidence: 99%

Fall injuries, associated deaths, and 30-day readmission for subsequent falls are increasing in the elderly US population: a query of the WHO mortality database and National Readmission Database from 2010 to 2014

Galet¹,

Zhou²,

Eyck³

et al. 2018

CLEP

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PurposeClinicians anecdotally noted that elderly patients who suffered from traumatic injuries (falls or other injuries) often re-present and are readmitted with fall injuries. Herein, we hypothesized that fall injuries and fall-related deaths and readmissions are increasing over time, and assessed whether the overall rates of death, hospital admission, and 30-day readmission due to falls increased from 2010 to 2014 in the elderly population (≥65) in the US.Patients and methodsThe WHO mortality database and the National Readmission Database (NRD) were queried to assess rates of deaths and hospital admissions and 30-day readmissions associated with fall injuries in the elderly population that presented with trauma. Descriptive statistics were obtained. The generalized linear mixed modeling (GLMM) framework was utilized to examine the relationship between fixed-effect predictor variables and the dichotomous outcome, indicating readmission within 30 days of previous discharge while accounting for hospital clustering with a random intercept.ResultsFall-related death increased by 1.4% from 2010 to 2014. Similarly, the hospital admission rate increased by 2% and was mainly associated with increased admission of elderly 65–74 years old. Approximately 55% of the fall patients were placed in nursing facilities in 2010, and this rate increased by 3% from 2010 to 2014. Thirty-day readmission rates for fall and trauma patients remained stable from 2010 to 2014. However, the rate of fall patients readmitted within 30 days for a subsequent fall increased from 15.6% to 17.4% between 2010 and 2014.ConclusionOur data indicate a steady increase in deaths and admissions for fall injuries in the elderly population. Strikingly, the incidence of readmission for a subsequent fall is increasing. With the aging population, this trend is likely to continue and highlights the need for elderly social support systems and fall prevention programs.

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“…Thus, the rate at which trauma patients return to an emergency department (ED) soon after discharge remains high. Prior investigations have identified that up to 14% of injured patients return to an ED within 30 days of their discharge [4][5][6][7][8]. The accuracy of this data is in question, as many patients do not return to the index hospital [5].…”

Section: Introductionmentioning

confidence: 99%

Victims of Violence and Post-Discharge Adverse Events: A Prospective Modified Trauma Quality Improvement Program (TQIP) Study

Gontarz¹,

Siddiqui²,

McGuiness³

et al. 2021

Cureus

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IntroductionTrauma patients frequently return to an emergency department (ED) soon after discharge; often for nonurgent reasons. Social factors contribute to higher ED usage. At present, there is no standardized system for reporting of ED visits and readmissions among trauma care. We hypothesized that victims of violent crime suffer from many early post-discharge adverse events that has not been captured by current methods. MethodsWe prospectively consented and enrolled injured patients from January 1st, 2019 to December 31st, 2019. We documented 30-day post-discharge events using post-discharge phone calls and detailed chart abstraction. Patients were categorized as victims of violence (VV) or unintentional traumatic injury (UT). ResultsDuring the study period, 444 patients were enrolled. Fifty-one (11.5%) were victims of violence and 393 (88.5%) experienced unintentional injuries. The VV patients were younger (40.10 vs 60.36; p<0.0001), and more predominantly male (92.16% vs 57.51%; p<0.0001). Total injury severity score (ISS), critical care length of stay (LOS), and total LOS were similar. VV patients were more likely discharged home (70.59% vs 55.47%; p=0.0403). They were significantly more likely to return to an emergency department (47.06% vs 23.16%; p<0.0005) and had more total number of ED visits per patient. Readmission rates, however, were not different (21.57% vs 16.28%; p=NS). The VV patients more frequently were underinsured (72.5%, vs 20.6%, p<0.005). DiscussionVictims of violence presented to the ED significantly more often, despite similar injury scores, LOS, and being of younger age. Of these patients, only 26.2% of ED presentations resulted in readmission, suggesting the majority of patient complaints may have been able to be managed in an office-based setting. VV had significantly more underinsured or subsidized patients. Victims of violence are vulnerable and may benefit from more resources provided in the early post-discharge period.

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Trauma patient readmissions

Abstract: Epidemiologic study, level III.

Cited by 39 publications

References 26 publications

Hospital Readmissions After Pediatric Trauma

Hospital Readmissions After Pediatric Trauma

Fall injuries, associated deaths, and 30-day readmission for subsequent falls are increasing in the elderly US population: a query of the WHO mortality database and National Readmission Database from 2010 to 2014

Victims of Violence and Post-Discharge Adverse Events: A Prospective Modified Trauma Quality Improvement Program (TQIP) Study

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