title: Early unplanned hospital readmission after acute traumatic injury: the experience at a state-designated level-I trauma center.
abstract: BACKGROUND
  There is limited literature on early unplanned hospital readmission after acute traumatic injury, especially at suburban facilities.
  
  
  METHODS
  A retrospective review of the trauma registry at a suburban, state-designated, level-I academic trauma center from July 2009 to June 2012 was performed for all admitted (≥24 hours) adult (age ≥18 years) trauma patients who were discharged alive, including unplanned readmissions within 30 days of discharge.
  
  
  RESULTS
  Of 3,622 admitted adult trauma patients, 6.57% were readmitted at a median of 9 days. Major surgery was required in 15.9% patients on readmission. The mortality rate at readmission was 4.6%. Multiple factors were associated with readmission on univariate analysis; however, on multivariate analysis, only major comorbidities (odds ratio [OR], 1.53), hospital length of stay (OR, 1.01), abdominal Abbreviated Injury Score greater than or equal to 3 (OR, 2.10), and discharge to a skilled nursing facility or subacute facility (OR, 1.56) were significant predictors. Meanwhile, index admission to surgical services was associated with a significantly lower readmission risk (OR, .60).
  
  
  CONCLUSIONS
  Trauma patients are infrequently readmitted. Index admission to a surgical service reduces the risk of readmission. Earlier medical follow-up should be considered.
authors.affiliation: Division of Trauma, Department of Surgery, Stony Brook University School of Medicine, HSC 18, Room 040, Stony Brook, NY 11794-8191.
authors.forename: Leonard M
authors.initials: LM
authors.lastname: Copertino
authors.affiliation: Division of Trauma, Department of Surgery, Stony Brook University School of Medicine, HSC 18, Room 040, Stony Brook, NY 11794-8191.
authors.forename: Jane E
authors.initials: JE
authors.lastname: McCormack
authors.affiliation: Division of Trauma, Department of Surgery, Stony Brook University School of Medicine, HSC 18, Room 040, Stony Brook, NY 11794-8191.
authors.forename: Daniel N
authors.initials: DN
authors.lastname: Rutigliano
authors.affiliation: Division of Trauma, Department of Surgery, Stony Brook University School of Medicine, HSC 18, Room 040, Stony Brook, NY 11794-8191.
authors.forename: Emily C
authors.initials: EC
authors.lastname: Huang
authors.affiliation: Division of Trauma, Department of Surgery, Stony Brook University School of Medicine, HSC 18, Room 040, Stony Brook, NY 11794-8191.
authors.forename: Marc J
authors.initials: MJ
authors.lastname: Shapiro
authors.affiliation: Division of Trauma, Department of Surgery, Stony Brook University School of Medicine, HSC 18, Room 040, Stony Brook, NY 11794-8191.
authors.forename: James A
authors.initials: JA
authors.lastname: Vosswinkel
authors.affiliation: Division of Trauma, Department of Surgery, Stony Brook University School of Medicine, HSC 18, Room 040, Stony Brook, NY 11794-8191. Electronic address: Randeep.jawa@stonybrookmedicine.edu.
authors.forename: Randeep S
authors.initials: RS
authors.lastname: Jawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000401:mortality / Q000628:therapy*
keywords: Suburban; Trauma; Trauma center; Unplanned readmission