The following is a summary of “Trauma – It is a party, but is everyone invited? A single center retrospective analysis of trauma patients at risk for early discharge after transfer,” published in the December 2023 issue of Surgery by Nix, et al.
Transferred trauma patients frequently are discharged after short stays without undergoing treatments. Strategies to decrease unnecessary transfers are needed.
For a study, researchers conducted a retrospective analysis of patients transferred to our level I center from 2019 to 2021. They identified patients discharged within 24 h without interventions and compared demographic, activation, injury, and mechanism of injury characteristics with patients requiring more care. A risk score was developed from these factors.
Of 2,424 patients transferred, 463(19%) were discharged within 24 h. In an integer score, age (1 pt), Injury Severity Score (<6 = 5 pts, 7–9 = 2 pts), recreational mechanism (3 pts), no hypertension (1 pt), no diabetes (2 pts), no dementia (3 pts), chest (1 pt), external (4 pts), face (5 pts) and Head/neck trauma (2 pts) were associated with early discharge. The score stratified the risk of early discharge from 4.8% (score <7) to 67% (score >15).
When prospectively validated, the risk score may identify patients who can be managed without transfer.
Reference: americanjournalofsurgery.com/article/S0002-9610(23)00320-3/fulltext