Background: After traumatic injury, 13-14% of patients utilize the emergency department (ED) and 11% are readmitted within 30 days. Decreasing ED visits and readmission represents a target for quality improvement. This cohort study evaluates risk factors for ED visits and readmission after trauma, focusing on outpatient follow-up.
Study design: We conducted a retrospective chart review of adult trauma admissions from 1/1/2018-12/31/2021. Our primary exposure was outpatient follow-up, our primary outcome was ED use, and our secondary outcome was readmission. Multivariable logistic regression evaluated the association between primary exposure and outcomes, adjusting for factors identified on unadjusted analysis.
Results: 2,266 patients met inclusion criteria, with an 11.3% ED visit rate and 4.1% readmission rate. Attending follow-up did not have a significant association with ED visits (OR 0.99, 95% CI 0.99-2.01, p=0.05) or readmission rates (OR 1.68, 95% CI 0.95-2.99, p=0.08). Significant associations with ED use included non-white race, depression, anxiety, substance use disorder, discharge disposition, and being discharged with lines or drains. Significant associations with readmission included depression, anxiety, and discharge disposition.
Conclusion: Emphasizing outpatient follow-up in trauma patients is not an effective target to decrease ED use or readmission. Future studies should focus on supporting patients with mental health comorbidities and investigating interventions to optimally engage with trauma patients after hospital discharge.
Copyright © 2024 by the American College of Surgeons. Published by Wolters Kluwer Health, Inc. All rights reserved.