Risk Factors for Unplanned Readmission in Older Trauma Patient

 

Patient selection: trauma patient >= 55 years of age having an unplanned readmission

 

Risk factors for unplanned readmission:

(1) severe head injury (maximum head AIS > 3)

(2) admission to the ICU on index admission

(3) discharge to skilled nursing facility (not independent at discharge)

(4) fall injury

 

The odds ratios for these were in the 1.3 to 1.5 range.

 

An older age was associated with greater risk for death without readmission but not for readmission.

 

ICD-9 diagnoses at unplanned readmission at 30 days, 6 months and 1 year:

(1) atrial fibrillation

(2) anemia

(3) congestive heart failure

(4) dehydration

(5) urinary tract infection

(6) acute renal failure

(7) pneumonia or aspiration pneumonia

(8) acute respiratory failure

(9) COPD exacerbation

(10) traumatic subdural hemorrhage (for 30-day unplanned readmission)

 

Many of these reasons indicate comorbid conditions. A Charlson Comorbidity Index >= 1 was associated with unplanned readmission at 6 and 12 months.