Factors associated with discharge destination from acute care after moderate-to-severe traumatic injuries in Norway: a prospective population-based study

• Published in: Injury Epidemiology
• Main Authors: Håkon Øgreid Moksnes, Christoph Schäfer, Mari Storli Rasmussen, Helene Lundgaard Søberg, Olav Røise, Audny Anke, Cecilie Røe, Pål Aksel Næss, Christine Gaarder, Eirik Helseth, Hilde Margrete Dahl, Morten Hestnes, Cathrine Brunborg, Nada Andelic, Torgeir Hellstrøm
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2023
• Subjects: Trauma; Trauma center; Traumatic injury; Multiple injury; Discharge destination; Epidemiology; Medical emergencies. Critical care. Intensive care. First aid; RC86-88.9; Public aspects of medicine; RA1-1270; Norway; Northern Norway
• Online Access: https://doi.org/10.1186/s40621-023-00431-y; https://doaj.org/article/17e58d4a59d14c49aeaa876ba25c5dfc

Abstract Background Previous studies have demonstrated that the trauma population has needs for rehabilitation services that are best provided in a continuous and coordinated way. The discharge destination after acute care is the second step to ensuring quality of care. There is a lack of knowledge regarding the factors associated with the discharge destination for the overall trauma population. This paper aims to identify sociodemographic, geographical, and injury-related factors associated with discharge destination following acute care at trauma centers for patients with moderate-to-severe traumatic injuries. Methods A multicenter, population-based, prospective study was conducted with patients of all ages with traumatic injury [New Injury Severity Score (NISS) > 9] admitted within 72 h after the injury to regional trauma centers in southeastern and northern Norway over a 1-year period (2020). Results In total, 601 patients were included; a majority (76%) sustained severe injuries, and 22% were discharged directly to specialized rehabilitation. Children were primarily discharged home, and most of the patients ≥ 65 years to their local hospital. Depending on the centrality of their residence [Norwegian Centrality Index (NCI) 1–6, where 1 is most central], we found that patients residing in NCI 3–4 and 5–6 areas sustained more severe injuries than patients residing in NCI 1–2 areas. An increase in the NISS, number of injuries, or a spinal injury with an Abbreviated Injury Scale (AIS) ≥ 3 was associated with discharge to local hospitals and specialized rehabilitation than to home. Patients with an AIS ≥ 3 head injury (RRR 6.1, 95% Confidence interval 2.80–13.38) were significantly more likely to be discharged to specialized rehabilitation than patients with a less severe head injury. Age < 18 years was negatively associated with discharge to a local hospital, while NCI 3–4, preinjury comorbidity, and increased severity of injuries in the lower extremities were positively associated. Conclusions Two-thirds ...