Predictive factors and models for trauma patient disposition.

Area of Science:

• Trauma surgery
• Health services research
• Patient outcomes

Background:

• Delays in disposition planning can unnecessarily prolong hospital length of stay for trauma patients.
• Early identification of patient variables can aid in disposition planning during hospitalization.

Purpose of the Study:

• To identify demographic and clinical predictors of discharge location in trauma patients.
• To develop clinical decision rules for early discharge planning.

Main Methods:

• Retrospective analysis of 2836 trauma patients.
• Univariate and multivariable logistic regression to identify predictors of discharge location (home, nonhome, rehabilitation).
• Development of two models: regular discharge (RD) and admission planning discharge (APD).

Main Results:

• Age, female sex, longer ICU/hospital stays, neurologic deficiencies, coagulopathy, diabetes, and obesity were independent predictors of nonhome discharge.
• The RD and APD models predicted discharge location with 87.2% and 82.9% accuracy, respectively.

Conclusions:

• Demographic and clinical information effectively predicts trauma patient disposition early in their hospital stay.
• Validated clinical decision rules can facilitate earlier discharge planning, enhancing patient satisfaction, rehabilitation, and cost savings.