Trauma patients with limited English proficiency: Outcomes from two level one trauma centers

Lydia R Maurer; Chukwuma N Eruchalu; Apostolos Gaitanidis; Majed El Hechi; Benjamin G Allar; Amina Rahimi EdM; Ali Salim; George C Velmahos; Numa P Perez; Claire de Crescenzo; April E Mendoza; Tanujit Dey; Haytham M Kaafarani; Gezzer Ortega

doi:10.1016/j.amjsurg.2022.10.043

Trauma patients with limited English proficiency: Outcomes from two level one trauma centers

Am J Surg. 2023 Apr;225(4):769-774. doi: 10.1016/j.amjsurg.2022.10.043. Epub 2022 Oct 19.

Affiliations

¹ Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
² Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, MA, USA.
³ Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
⁴ Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
⁵ Division of Trauma, Burn, and Surgical Critical Care, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
⁶ Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Healthcare Transformation Lab, Massachusetts General Hospital, Boston, MA, USA.
⁷ Center for Surgery and Public Health, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: Gortega1@bwh.harvard.edu.

PMID: 36302697
DOI: 10.1016/j.amjsurg.2022.10.043

Abstract

Background: Outcomes for surgical patients with limited English proficiency (LEP) may be worse compared to patients with English proficiency. We sought to evaluate the association of LEP with outcomes for trauma patients.

Methods: Admitted adult patients on trauma service at two Level One trauma centers from 2015 to 2019 were identified.

Results: 12,562 patients were included in total; 7.3% had LEP. On multivariable analyses, patients with LEP had lower odds of discharge to post-acute care versus home compared to patients with English proficiency (OR 0.69; 95% CI 0.58-0.83; p < 0.001) but had similar length of stay (Beta coefficient 1.16; 95% CI 0.00-2.32; p = 0.05), and 30-day readmission (OR 1.08; 95% CI 0.87-1.35; p = 0.46).

Conclusions: Trauma patients with LEP had comparable short-term outcomes to English proficient patients but were less likely to be discharged to post-acute care facilities. The role of structural barriers, family preferences, and other factors merit future investigation.

Keywords: Discharge; Limited English proficiency; Post-acute care; Trauma surgery.

MeSH terms

Adult
Communication Barriers
Humans
Language
Limited English Proficiency*
Patient Readmission
Trauma Centers