Effect of Hospital Length of Stay on Functional Independence Measure Score in Trauma Patients
after-discharge; alcohol; anemia; association; brain-injury; Function; injury severity score; intensive-care-unit; Length of Stay; life; outcomes; Patient Outcome Assessment; Recovery of; Rehabilitation; Rehabilitation; Sport Sciences; survival
Objective: The purpose of this study was to determine whether prolonged hospital length of stay (HLOS) and rehabilitation facility length of stay (RLOS) lead to poor functional outcomes, defined as a Functional Independence Measure (FIM) score of less than 76 (LFIM) at rehabilitation facility (RF) discharge. Design: This study analyzed retrospective data collected between 2002 and 2009 on 326 patients in a trauma center and affiliated RF. Factors predicting LFIM at RF discharge were determined using multivariate logistic regression, chi(2) tests, and t tests. Results: Significant multivariate predictors of LFIM included age (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.02-1.07; P < 0.0001), spinal cord injury (OR, 7.22; 95% CI, 2.73-19.02; P = 0.000), female sex (OR, 2.34; 95% CI, 1.17-4.65; P = 0.01), and RF admission FIM (OR, 0.93; 95% CI, 0.91Y0.95; P < 0.001). An increased risk of LFIM (OR, 2.21; 95% CI, 1.41Y3.45; P = 0.001) was observed with an increased ratio of HLOS/RLOS after adjusting for injury severity score. Conclusion: An increased ratio of HLOS/RLOS increases the risk of LFIM more than 2-fold after adjusting for injury severity score, spinal cord injury, and FIM upon RF admission. Delays in transfer to an RF negatively affect patient functional outcomes. Studies to identify factors affecting delays in transfer from hospitals to RF should be conducted.
Muakkassa F F; Marley R A; Billue K L; Marley M; Horattas S; Yetmar Z; Salvator A; Hayek A
American Journal of Physical Medicine & Rehabilitation
2016
2016-08
Journal Article
<a href="http://doi.org/10.1097/phm.0000000000000453" target="_blank" rel="noreferrer noopener">10.1097/phm.0000000000000453</a>
Incidental findings in the cervical spine at CT for trauma evaluation.
Adult; Female; Humans; Male; Middle Aged; Adolescent; Aged; Retrospective Studies; Registries; Incidental Findings; Injury Severity Score; Length of Stay/statistics & numerical data; Data Collection; Tomography; Human; Middle Age; Adolescence; Retrospective Design; Diagnosis; Cervical Vertebrae/*diagnostic imaging/*injuries; Spinal Injuries/*diagnostic imaging; 80 and over; X-Ray Computed/*methods; Nonparametric; Statistics; Nonparametric Statistics; Trauma Severity Indices; 80 and Over; Length of Stay – Statistics and Numerical Data; X-Ray Computed – Methods; Cervical Vertebrae – Injuries; Cervical Vertebrae – Radiography; Spinal Injuries – Radiography
OBJECTIVE: CT is the standard of care for assessment of traumatic injuries. Because of the detail depicted with this technique, findings incidental to the injury are easily detected. We sought to determine the frequency and types of incidental findings in the cervical spines of trauma patients undergoing CT. MATERIALS AND METHODS: The trauma registry was accessed to identify the cases of patients evaluated with cervical spine CT at a level 1 trauma center from January to July 2007. Trauma registry data, including age, sex, injury severity score, mechanism of injury, length of stay, and diagnosis were recorded, and all CT scans of the cervical spine were reviewed for incidental findings. Clinically significant incidental findings were classified according to bodily location, and the association between various patient characteristics and the likelihood of an incidental finding was assessed. RESULTS: We identified incidental CT findings in 230 of 1,256 patients (18.3%) who underwent CT of the cervical spine during an initial trauma evaluation. We stratified the incidental findings as trauma-related and not trauma-related. The likelihood of non-trauma-related incidental findings was associated with age (p \textless 0.0001). The likelihood of trauma-related incidental findings was associated with injury severity score (p \textless 0.0001). CONCLUSION: Incidental findings in the cervical spine were associated with age, injury severity score, and mechanism of injury. Awareness of the prevalence of incidental findings is important to assuring that both traumatic and nontraumatic pathologic findings are detected and appropriately managed.
Barboza Richard; Fox Jason H; Shaffer Lynn E T; Opalek Judy M; Farooki Shella
AJR. American journal of roentgenology
2009
2009-03
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
<a href="http://doi.org/10.2214/AJR.08.1420" target="_blank" rel="noreferrer noopener">10.2214/AJR.08.1420</a>