title: Is it safe to admit patients with acute injuries to nonsurgical services? A retrospective review.
abstract: BACKGROUND
  Given potential safety risks when admitting injured patients to nonsurgical services (NSS), the American College of Surgeons mandates trauma centers justification. However, evidence supporting this requirement is lacking.
  
  
  METHODS
  Adult patients cleared for admission to a NSS at a level 1 trauma center between 2012 and 2014 were retrospectively reviewed. Patient demographic, injury, and outcome characteristics were compared between nonsurgical (NSA) and surgical admission patients and analyzed for predictive value.
  
  
  RESULTS
  Compared with surgical admission patients, NSA patients were significantly older, had a higher number of comorbidities and/or patient and a lower Injury Severity Score, while hospital length of stay, complications, and missed injury and adjusted mortality rates were similar. NSA did not predict mortality whereas increased age, increased Injury Severity Score, and number of comorbidities and/or patient did.
  
  
  CONCLUSIONS
  As all complications and mortalities were unrelated to injuries per se, admission to a NSS, after protocoled clearance by a trauma or Emergency Department attending, appears to be safe.
authors.affiliation: Tufts University School of Medicine, Boston, MA, USA. Electronic address: alyssa.tutunjan@tufts.edu.
authors.forename: Alyssa M
authors.initials: AM
authors.lastname: Tutunjian
authors.affiliation: Tufts University School of Medicine, Boston, MA, USA; Division of Trauma & Acute Care Surgery, Tufts Medical Center, Boston, MA, USA.
authors.forename: Nikolay
authors.initials: N
authors.lastname: Bugaev
authors.affiliation: Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA; Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
authors.forename: Janis L
authors.initials: JL
authors.lastname: Breeze
authors.affiliation: Tufts University School of Medicine, Boston, MA, USA; Division of Trauma & Acute Care Surgery, Tufts Medical Center, Boston, MA, USA.
authors.forename: Sandra S
authors.initials: SS
authors.lastname: Arabian
authors.affiliation: Tufts University School of Medicine, Boston, MA, USA; Division of Trauma & Acute Care Surgery, Tufts Medical Center, Boston, MA, USA.
authors.forename: Reuven
authors.initials: R
authors.lastname: Rabinovici
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010343:Patient Admission; D018579:Patient Selection; D012189:Retrospective Studies; D013503:Surgery Department, Hospital; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000150:complications / Q000175:diagnosis / Q000628:therapy*
keywords: Admission; Nonsurgical; Outcomes; Trauma center