Predictors of Trauma High Resource Consumers in a Mature Trauma System

The American Surgeon
Madison E MorganFrederick B Rogers

Abstract

Extended hospital length of stay (LOS) is widely associated with significant healthcare costs. Since LOS is a known surrogate for cost, we sought to evaluate outliers. We hypothesized that particular characteristics are likely predictive of trauma high resource consumers (THRC) and can be used to more effectively manage care of this population. The Pennsylvania Trauma Outcome Study database was retrospectively queried from 2003-2017 for all adult (age ≥15) trauma patients admitted to accredited trauma centers in Pennsylvania. THRC were defined as patients with hospital LOS two standard deviations above the population mean or ≥22 days (p<0.05). Patient demographics, comorbid conditions and clinical variables were compared between THRC and non-THRC to identify potential predictor variables. A multilevel mixed-effects logistic regression model controlling for age, gender, injury severity, admission Glasgow coma score, systolic blood pressure, and injury year assessed the adjusted impact of clinical factors in predicting THRC status. The National Trauma Data Bank (NTDB) was retrospectively queried from 2014-2016 for all adult (age ≥15) trauma patients admitted to state-accredited trauma centers and likewise were assessed for factor...Continue Reading

References

Apr 18, 2003·Acta Anaesthesiologica Scandinavica·K StrickerJ Takala
May 15, 2010·BMC Medical Informatics and Decision Making·Andrew A Kramer, Jack E Zimmerman
Apr 26, 2014·Journal of Intensive Care Medicine·Bryan R TischenkelLewis A Eisen
May 10, 2016·Injury·Charles DiMaggioSpiros Frangos

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Citations

Apr 17, 2021·The American Journal of Emergency Medicine·Mason SutherlandAdel Elkbuli

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