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Readmission of trauma patients in a nonacademic Level II trauma center

Vachon, Christopher M. BA; Aaland, Mary MD, FACS; Zhu, Thein Hlaing MBBS, FACE

Journal of Trauma and Acute Care Surgery: February 2012 - Volume 72 - Issue 2 - p 531–536
doi: 10.1097/TA.0b013e3182326172
Original Articles

Background: Readmission of trauma patients has been identified as a quality indicator for trauma care. Few if any studies on this topic can be found from a nonacademic trauma center. The objectives of the study were to determine the rate, cause, and preventability for readmission and to identify predictors of readmission in a nonacademic trauma center.

Methods: Cases registered from 2007 to 2009 were identified from trauma registry. A retrospective chart review of 98 readmission trauma patients was done to elicit the complications and outcomes. Criteria were selected to elicit preventability of readmissions. Predictors for readmission were identified by using a logistic regression analysis.

Results: Of 4,986 patients, 98 (1.96%) required readmission due to wound (23.47%), abdominal (16.33%), thromboembolic (4.08%), central nervous system (21.43%), hematoma (5.10%), and pulmonary (7.14%) complications. Among all readmission cases, surgery was performed in 38.78%, days to readmission was 19.44 ± 8.80, and six patients experienced a readmission chain. Penetrating injury, Injury Severity Score >25, and hospital length of stay were predictors of readmission. 90.82% of the trauma readmissions were trauma related and 15% were potentially preventable readmissions. Fifty-three percent of the readmissions occurred before a follow-up appointment.

Conclusions: The incidence of readmissions was similar to published data from academic trauma centers, but the reason for readmission and the need for surgery at readmission were very different. Potentially preventable readmissions have not been well addressed in literature. Therefore, further multicenter studies that include nonacademic trauma centers are needed to analyze this complicated problem.

Fargo, North Dakota

From the Indiana University School of Medicine (C.M.V.), Indianapolis, Indiana; Sanford Health (M.A.), Fargo, North Dakota; and Parkview Hospital (T.H.Z.), Fort Wayne, Indiana.

Submitted: March 7, 2011, Revised: June 16, 2011, Accepted: August 11, 2011.

Address for reprints: Mary Aaland, MD, FACS, Sanford Health, 737 Broadway, Fargo, ND 58122; email: maryaaland@gmail.com.

© 2012 Lippincott Williams & Wilkins, Inc.