Predictors of discharge destination in patients with major traumatic injury: Analysis of Oklahoma Trauma Registry

Am J Surg. 2019 Sep;218(3):496-500. doi: 10.1016/j.amjsurg.2018.11.045. Epub 2018 Dec 10.

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.

Keywords: Discharge destination; Discharge disposition; Discharge planning; Predictive factor; Trauma.

Publication types

  • Validation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Models, Statistical*
  • Oklahoma
  • Patient Discharge*
  • Patient Transfer*
  • Registries
  • Retrospective Studies
  • Wounds and Injuries