Abstract
Background
Unplanned hospital readmissions within 30 days of discharge for trauma (UR-30) are associated with adverse outcomes but remain underexplored in trauma populations.
Methods
This study retrospectively reviewed 164 trauma patients at a Level I center during 2022-2023, analyzing demographics, comorbidities, injury severity, socioeconomic factors, medications, and hospital events. Propensity matching ensured comparability between 82 UR-30 and 82 patients not readmitted (NoReadmission-30).
Results
Key findings include median hospital length of stay (LOS) of 5 days for UR-30 vs 3 days for NoReadmission-30 (P = .022) and ICU LOS of 2 vs 0 days (P < .001), respectively. Final in-hospital hemoglobin was lower in UR-30 (10.7 vs 12; P = .014). Discharge home rates were lower for UR-30 (51.2% vs 69.5%; P = .017). Transfusion requirements significantly increased readmission risk, with UR-30 patients 6.7 times more likely to be readmitted. Significant comorbidities included smoking (P = .042), hyperlipidemia (P = .012), CHF (P = .013), substance use disorder (P = .043), and ≥3 comorbid diagnoses (P = .001). Most readmissions were for infections, neurological decline, and inadequate pain control. Discharge on anticoagulants (P = .007) or with ≥7 discharge medications (P < .001) increased readmission likelihood, while chronic NSAID use reduced it (P = .046). Family as PoA was more common in UR-30 (83% vs 40%; P < .001). Non-significant factors included discharge vital signs, injury mechanism, insurance, and race.
Discussion
UR-30 occurs predominantly in moderately injured patients and is influenced by ICU and hospital LOS, discharge disposition, comorbidities, and transfusion status, underscoring its value as a trauma quality metric.
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