6 things to know about orthopedic trauma readmissions & outcomes

Orthopedic

The Journal of Orthopaedic Trauma published a study assessing predictors of readmission after orthopedic trauma surgery.


The study included 3,452 skeletal trauma operations from 2008 to 2012. The researchers tallied readmissions to the hospital within 30 days of surgery. The researchers found:

1. Thirty-day readmission significantly associated with higher Charleston comobiridity index, older age and widowed individuals.

2. Readmission factors related to adverse events were identical: higher CCI, older age and marital status.

3. CCI and older age were related to readmissions in the best multivariable logistical regression models for all-cause 30-day readmissions and 30-day readmissions related to surgical adverse events. This "reflects the complexity of readmission and difficulty reducing the risk to a few specific factors," concluded study authors.

4. A separate study of orthopedic trauma patients at a Level 1 trauma center in the same issue of the Journal of Orthopaedic Trauma found depression prevalent among patients. There were 110 patients enrolled in the study at the time of injury and 22 patients with moderate-to-major depression; 36 patients had mild depression. Depression can negatively impact the orthopedic patient experience and treatment outcomes.

5. A history of drug use and lower Duke Societal Support and Stress Scale support scores were significant factors for patients with mild depression at the time of surgery. Other factors for mild-to-major depression at the time of injury include:

•    History of psychiatric diagnosis
•    Unemployment
•    Medicaid insurance

6. Injury severity did not impact depression scores, according to the study. "Targeted consultation with a mental healthcare provider may obviate any morbidity that is associated with depression in an injured patient," concluded the study authors.

 

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