TY  - JOUR
PY  - 2020//
TI  - Nationwide outcomes and risk factors for reinjury after penetrating trauma
JO  - Journal of surgical research
A1  - Parreco, Joshua
A1  - Sussman, Matthew S.
A1  - Crandall, Marie
A1  - Ebler, David J.
A1  - Lee, Eugenia
A1  - Namias, Nicholas
A1  - Rattan, Rishi
SP  - 59
EP  - 69
VL  - 250
IS  - 
N2  - BACKGROUND: Previous studies have shown that a notable portion of patients who are readmitted for reinjury after penetrating trauma present to a different hospital. The purpose of this study was to identify the risk factors for reinjury after penetrating trauma including reinjury admissions to different hospitals. <br><br>METHODS: The 2010-2014 Nationwide Readmissions Database was queried for patients surviving penetrating trauma. E-codes identified patients subsequently admitted with a new diagnosis of blunt or penetrating trauma. Univariable analysis was performed using 44 injury, patient, and hospital characteristics. Multivariable logistic regression using significant variables identified risk factors for the outcomes of reinjury, different hospital readmission, and in-hospital mortality after reinjury. <br><br>RESULTS: There were 443,113 patients identified. The reinjury rate was 3.5%. Patients presented to a different hospital in 30.0% of reinjuries. Self-inflicted injuries had a higher risk of reinjury (odds ratio [OR]: 2.66, P < 0.05). Readmission to a different hospital increased risk of mortality (OR: 1.62, P < 0.05). Firearm injury on index admission increased risk of mortality after reinjury (OR: 1.94, P < 0.05). <br><br>CONCLUSIONS: This study represents the first national finding that one in three patients present to a different hospital for reinjury after penetrating trauma and have a higher risk of mortality due to this fragmentation of care. These findings have implications for quality and cost improvements by identifying areas to improve continuity of care and the implementation of penetrating injury prevention programs.<br><br>Copyright © 2020 Elsevier Inc. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 0022-4804
UR  - http://dx.doi.org/10.1016/j.jss.2019.12.029
ID  - ref1
ER  -