Trauma patients: you can get them in, but you can't get them out.
BACKGROUND
The majority of inpatient trauma care resources are consumed by a small proportion of severely injured patients.


METHODS
Hospital lengths of stay (LOS), resource consumption, and postdischarge placement were abstracted from the institutional trauma registry.


RESULTS
Patients (n = 4,070) were evaluated by the trauma service during the study period. The overall mean LOS was 4.4 days, and beds were occupied on 18,005 days. Two hundred forty-four (6%) patients remained in the hospital >14 days after injury and occupied beds on 8,560 (47%) days. These patients were older, more severely injured, and required proportionately more intensive care unit and operative care. Injuries to the head, abdomen, and extremities were independently associated with longer LOS. Most patients with longer LOS were placed in long-term acute care or received home nursing care after discharge.


CONCLUSIONS
Almost half of inpatient trauma bed-days are occupied by a small proportion of patients with long-term care needs.
Ciesla
David J
DJ
Department of Surgery, Washington Hospital Center, Washington, DC, USA. david.j.ciesla@medstar.net
Sava
Jack A
JA
Kennedy
Susan O
SO
Levinson
Karen
K
Jordan
Marion H
MH
D000328:Adult; D000359:Aftercare / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004219:District of Columbia; D005260:Female; D015276:Health Care Rationing / Q000458:organization & administration*; D006295:Health Resources / Q000706:statistics & numerical data*; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D012042:Registries; D019467:Subacute Care; D013997:Time Factors; D014193:Trauma Centers / Q000706:statistics & numerical data*; D015599:Trauma Severity Indices; D014600:Utilization Review; D014947:Wounds and Injuries / Q000175:diagnosis / Q000534:rehabilitation / Q000628:therapy*