Citation

Khorgami Z, Ewing KL, Mushtaq N, Chow GS, Howard CA. Am. J. Surg. 2018; ePub(ePub): ePub.

Affiliation

Department of Surgery, The University of Oklahoma, College of Medicine, Tulsa, OK, USA. Electronic address: tony-howard@ouhsc.edu.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.amjsurg.2018.11.045

PMID

30558804

Abstract

BACKGROUND: The ability to predict the need for discharge of trauma patients to a facility may help shorten hospital stay. This study aimed to determine the predictors of discharge to a facility and develop and validate a predictive scoring model, utilizing the Oklahoma Trauma Registry (OTR).

METHODS: A multivariate analysis of the OTR 2005-2013 determined independent predictors of discharge to a facility. A scoring model was developed, and positive and negative predictive values (PPV and NPV) were evaluated for 2014 patients.

RESULTS: 101,656 patients were analyzed. The scoring model included age≥50 years, lower extremity fracture, ICU stay≥5 days, pelvic fracture, intracranial hemorrhage, congestive heart failure, cardiac dysrhythmia, history of CVA or TIA, and ISS≥15, spine fracture, diabetes mellitus, hypertension, ischemic heart disease, and chronic obstructive pulmonary disease. Applying the model to 2014 patients, PPV for predicting discharge to a facility was 84.9% for scores≥15, and NPV was 90.5% for scores<8.

CONCLUSION: A scoring model including age, trauma severity, types of injury, and comorbidities could predict discharge of trauma patients to a facility. Further studies are needed to refine the efficacy of the model.

Copyright © 2018 Elsevier Inc. All rights reserved.

Language: en

Keywords

Discharge destination; Discharge disposition; Discharge planning; Predictive factor; Trauma