American journal of surgery · 2023
Trauma - It is a party, but is everyone invited? A single center retrospective analysis of trauma patients at risk for early discharge after transfer.
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Nix Sean, Watkins Madelynn, Benedict Andrew, Nix Heather, Torres Kabir, Gazzetta Joshua, Fesmire Alyssa, Kennedy Kevin, Spertus John A
Аннотация
BACKGROUND: Transferred trauma patients frequently are discharged after short stays without undergoing treatments. Strategies to decrease unnecessary transfers are needed.
METHODS: We conducted a retrospective analysis of patients transferred to our level I center from 2019 to 2021. We identified patients discharged within 24 h without interventions and compared demographic, activation, injury, and mechanism of injury characteristics with patients requiring more care. A risk score was developed from these factors.
RESULTS: Of 2424 patients transferred, 463(19%) were discharged within 24 h. In an integer score, age (1 pt), Injury Severity Score (<6 = 5 pts, 7-9 = 2 pts), recreational mechanism (3 pts), no hypertension (1 pt), no diabetes (2 pts), no dementia (3 pts), chest (1 pt), external (4 pts), face (5 pts) and Head/neck trauma (2 pts) were associated with early discharge. The score stratified risk of early discharge from 4.8% (score <7) to 67% (score >15).
CONCLUSION: When prospectively validated the risk score may identify patients who can be managed without transfer.
METHODS: We conducted a retrospective analysis of patients transferred to our level I center from 2019 to 2021. We identified patients discharged within 24 h without interventions and compared demographic, activation, injury, and mechanism of injury characteristics with patients requiring more care. A risk score was developed from these factors.
RESULTS: Of 2424 patients transferred, 463(19%) were discharged within 24 h. In an integer score, age (1 pt), Injury Severity Score (<6 = 5 pts, 7-9 = 2 pts), recreational mechanism (3 pts), no hypertension (1 pt), no diabetes (2 pts), no dementia (3 pts), chest (1 pt), external (4 pts), face (5 pts) and Head/neck trauma (2 pts) were associated with early discharge. The score stratified risk of early discharge from 4.8% (score <7) to 67% (score >15).
CONCLUSION: When prospectively validated the risk score may identify patients who can be managed without transfer.