A Contemporary Analysis of Delayed Diagnoses After Traumatic Injury

Abstract

Background

Factors associated with delayed injury diagnosis (DID) have been examined, but incompletely researched.

Methods

We evaluated demographics, mechanism, and measures of mental status and injury severity among 10 years’ worth of adult trauma patients at our center for association with DID in a multivariable regression model. Descriptions of DID injuries were reviewed to highlight characteristics of these injuries.

Results

We included 13 509 patients, 89 (0.7%) of whom had a recognized DID. In regression analysis, ISS (OR 1.04 per point, 95% CI 1.02-1.06) and number of injuries (OR 1.08 per injury, 95% CI 1.04-1.11) were associated with DID. Operative patients had twice the odds of DID (OR 2.02, 95% CI 1.18-3.44). The most common category of DID was orthopedic extremity injury (22/89).

Conclusion

DID is associated with injury severity and operative intervention. This suggests that the presence of an injury requiring operation may distract the trauma team from additional injuries.