- Title
- Determinants of long-term unplanned readmission and mortality following self-inflicted and non-self-inflicted major injury: a retrospective cohort study
- Creator
- Mitchell, Rebecca J.; Harris, Ian A.; Balogh, Zsolt J.; Curtis, Kate; Burns, Brian; Seppelt, Ian; Brown, Julie; Sarrami, Pooria; Singh, Hardeep; Levesque, Jean-Frederic; Dinh, Michael
- Relation
- European Journal of Trauma and Emergency Surgery Vol. 48, Issue 3, p. 2145-2156
- Publisher Link
- http://dx.doi.org/10.1007/s00068-021-01837-3
- Publisher
- Springer
- Resource Type
- journal article
- Date
- 2022
- Description
- Purpose: To describe the characteristics of major injury and identify determinants of long-term unplanned readmission and mortality after self-inflicted and non-self-inflicted injury to inform potential readmission screening. Method: A retrospective cohort study of 11,269 individuals aged ≥ 15 years hospitalised for a major injury during 2013–2017 in New South Wales, Australia. Unplanned readmission and mortality up to 27-month post-injury were examined. Logistic regression was used to examine predictors of unplanned readmission. Results: During the 27-month follow-up, 2700 (24.8%) individuals with non-self-inflicted and 98 (26.1%) with self-inflicted injuries had an unplanned readmission. Individuals with an anxiety-related disorder and a non-self-inflicted injury who were discharged home were three times more likely (OR: 3.27; 95%CI 2.28–4.69) or if they were discharged to a psychiatric facility were four times more likely (OR: 4.11; 95%CI 1.07–15.80) to be readmitted. Compared to individuals aged 15–24 years, individuals aged ≥ 65 years were 3 times more likely to be readmitted (OR 3.12; 95%CI 2.62–3.70). Individuals with one (OR 1.60; 95%CI 1.39–1.84) or ≥ 2 (OR 1.88; 95%CI 1.52–2.32) comorbidities, or who had a drug-related dependence (OR 1.88; 95%CI 1.52–2.31) were more likely to be readmitted. The post-discharge age-adjusted mortality rate following a self-inflicted injury (35.6%; 95%CI 29.9–41.8) was higher than for individuals with a non-self-inflicted injury (11.0%; 95%CI 10.4–11.8). Conclusions: Unplanned readmission after injury is associated with injury intent, age, and comorbid health. Screening for anxiety and drug-related dependence after major injury, accompanied by service referrals and post-discharge follow-up, has potential to prevent readmission.
- Subject
- injury; self-harm; readmission; mortality
- Identifier
- http://hdl.handle.net/1959.13/1463454
- Identifier
- uon:46740
- Identifier
- ISSN:1863-9933
- Language
- eng
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