Trauma - It is a party, but is everyone invited? A single center retrospective analysis of trauma patients at risk for early discharge after transfer

Abstract

Background: Transferred trauma patients frequently are discharged after short stays without undergoing treatments. Strategies to decrease unnecessary transfers are needed.

Methods: We conducted a retrospective analysis of patients transferred to our level I center from 2019 to 2021. We identified patients discharged within 24 h without interventions and compared demographic, activation, injury, and mechanism of injury characteristics with patients requiring more care. A risk score was developed from these factors.

Results: Of 2424 patients transferred, 463(19%) were discharged within 24 h. In an integer score, age (1 pt), Injury Severity Score (<6 = 5 pts, 7-9 = 2 pts), recreational mechanism (3 pts), no hypertension (1 pt), no diabetes (2 pts), no dementia (3 pts), chest (1 pt), external (4 pts), face (5 pts) and Head/neck trauma (2 pts) were associated with early discharge. The score stratified risk of early discharge from 4.8% (score <7) to 67% (score >15).

Conclusion: When prospectively validated the risk score may identify patients who can be managed without transfer.

Keywords: Early discharge; Risk score; Trauma; Unnecessary transfer.