Hospital readmission after trauma: an analysis of outpatient complications.
BACKGROUND
Outpatient complications leading to hospital readmission after hospitalization for trauma have not been examined.


METHODS
A retrospective chart review of all trauma victims admitted to a Level 1 trauma center from January of 1990 to January of 1995 was performed to characterize patients who required readmission after hospitalization for trauma. Risk factors for readmission were determined by stepwise regression analysis.


RESULTS
Of 15,463 trauma admissions, 209 patients (1.4%) required readmission, 84% within 30 days, 71% within 14 days. Reasons for readmission included wound (29%), abdominal (29%), pulmonary (18%), and thromboembolic (19%) complications. Fifty of the patients (24%) readmitted with a complication required an operation. Risk factors for readmission included: operation during first hospitalization (p < 0.0001), penetrating injury (p = 0.0001), and advanced age (p = 0.0001). Injury Severity Score, length of hospitalization, and gender were not independent predictors of readmission.


CONCLUSIONS
Outpatient complications leading to readmission after hospitalization for trauma are not common; however, many are serious and require operative intervention. Because most complications were identified by the second week after discharge, outpatient follow-up visits should be scheduled within 7 to 14 days. Based on our findings, we recommend protocols be established to ensure follow-up for trauma patients, especially those who have had an operation, were victims of penetrating injury, or those > 65 years of age.
Battistella
F D
FD
Department of Surgery, University of California, Davis, Medical Center, Sacramento 95817-2214, USA.
Torabian
S Z
SZ
Siadatan
K M
KM
D000328:Adult; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014947:Wounds and Injuries / Q000150:complications*