The burden of excess length of stay in trauma patients

Prakash J Mathew; Faisal Jehan; Narong Kulvatunyou; Muhammad Khan; Terence O'Keeffe; Andrew Tang; Lynn Gries; Mohammad Hamidi; El-Rasheid Zakaria; Bellal Joseph

doi:10.1016/j.amjsurg.2018.07.044

The burden of excess length of stay in trauma patients

Am J Surg. 2018 Nov;216(5):881-885. doi: 10.1016/j.amjsurg.2018.07.044. Epub 2018 Jul 31.

Authors

Affiliations

¹ Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].
² Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].
³ Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].
⁴ Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].
⁵ Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].
⁶ Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].
⁷ Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].
⁸ Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].
⁹ Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].
¹⁰ Division of Trauma, Critical Care, Emergency Surgery, and Burns, Department of Surgery, University of Arizona, Tucson, AZ, USA. Electronic address: [email protected].

PMID: 30082028
DOI: 10.1016/j.amjsurg.2018.07.044

Abstract

Background: Disposition of trauma patients frequently results in excessive hospital-stay. The aim of this study was to assess the risk of developing complications due to excessive stay in the hospital.

Methods: Over a period of 4 years (2012-2015) we analyzed all trauma patients with hospital length-of-stay (h-LOS) >30 days. Outcome measures were complications after termination of medical care.

Results: 416 patients were identified having h-LOS>30 days of which 61.0% (254) had an excess hospital stay and were included. The most common causes of excess hospital stay were placement in SNiF followed by placement in Inpatient-Rehabilitation. Excessive hospital-stay was independently associated with the development of complications (p = 0.004). Each excess day in the hospital after completion of medical care was associated with 5% higher odds of complications (OR [95%CI]: 1.05[1.02-1.09]) independent of presenting condition of the patient.

Conclusion: Each extra day spent in the hospital after completion of medical care was associated with higher odds of developing complications.

Keywords: Complications; Discharge barriers in trauma; Excess length of stay.

MeSH terms

Adult
Female
Follow-Up Studies
Health Expenditures / trends*
Hospital Costs*
Humans
Inpatients*
Length of Stay / economics
Length of Stay / trends*
Male
Retrospective Studies
Time Factors
Trauma Centers / economics*
United States
Wounds and Injuries / economics*
Wounds and Injuries / therapy