Citation

Staudt A, Gurney J, Valdez-Delgado K, Suresh M, Trevino J, Le T, Seery J, Shackelford S, Nessen S, Mann-Salinas E. J. Trauma Acute Care Surg. 2018; 85(1S Suppl 2): S140-S144.

Affiliation

US Army Institute of Surgical Research, San Antonio, TX.

Copyright

(Copyright © 2018, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0000000000001843

PMID

29443866

Abstract

BACKGROUND: Understanding patients' length of stay at far-forward Role 2 surgical units may help to determine support needs, stabilization requirements, pre-deployment training, and necessity of increased care capability prior to or during transport to a higher level of care. The objectives of this study were to 1) evaluate the amount of time patients spent at Role 2 and 2) determine factors associated with trauma patients' length of stay at Role 2.

METHODS: We conducted a secondary data analysis of the Joint Trauma System Role 2 Database. Logistic regression was used to determine factors associated with extended length of stay at Role 2.

RESULTS: There were 7,912 study patients, and the overall median (IQR) amount of time patients spent at Role 2 was 2.5 (1.2-5.5) hours. The adjusted odds ratio (aOR) of extended stay for Civilian/Other Forces and non-U.S. military patients were 1.2 (95% CI= 1.0, 1.4) and 1.4 (95% CI= 1.2, 1.7) times higher as compared to U.S. military patients, respectively. The aOR of extended stay were higher for patients who received blood transfusions (aOR=1.4, 95% CI= 1.2, 1.6), surgical procedures (aOR=1.6, 95% CI= 1.4, 1.8), or did not use a tourniquet (aOR=1.2, 95% CI= 1.0, 1.5). As compared to those injured by an explosion, the adjusted odds of extended stay were 1.2 (95% CI 1.0, 1.4) times higher for patients injured by another mechanism. The odds of extended stay were lower (aOR=0.3, 95% CI 0.2, 0.5) for patients who died and higher (aOR=1.4, 95% CI 1.2, 1.6) for transferred patients as compared to patients who returned to duty.

CONCLUSIONS: In this study, interventions, patient affiliation, discharge status, and injury mechanism were associated with length of stay at Role 2. Our study results will help inform training and current Role 2 logistic and personnel support needs. EVIDENCE LEVEL: level III STUDY TYPE: Prognostic.

Language: en