Risk Factor Analysis for Trauma Patients Readmitted Within 30 Days

Background Unplanned hospital readmissions within 30 days of discharge for trauma (UR-30) are associated with adverse outcomes but remain underexplored in trauma populations. Methods This study retrospectively reviewed 164 trauma patients at a Level I center during 2022-2023, analyzing demographics, comorbidities, injury severity, socioeconomic factors, medications, and hospital events. Propensity matching ensured comparability between 82 UR-30 and 82 patients not readmitted (NoReadmission-30). Results Key findings include median hospital length of stay (LOS) of 5 days for UR-30 vs 3 days for NoReadmission-30 ( P = .022) and ICU LOS of 2 vs 0 days ( P < .001), respectively. Final in-hospital hemoglobin was lower in UR-30 (10.7 vs 12; P = .014). Discharge home rates were lower for UR-30 (51.2% vs 69.5%; P = .017). Transfusion requirements significantly increased readmission risk, with UR-30 patients 6.7 times more likely to be readmitted. Significant comorbidities included smoking ( P = .042), hyperlipidemia ( P = .012), CHF ( P = .013), substance use disorder ( P = .043), and ≥3 comorbid diagnoses ( P = .001). Most readmissions were for infections, neurological decline, and inadequate pain control. Discharge on anticoagulants ( P = .007) or with ≥7 discharge medications ( P < .001) increased readmission likelihood, while chronic NSAID use reduced it ( P = .046). Family as PoA was more common in UR-30 (83% vs 40%; P < .001). Non-significant factors included discharge vital signs, injury mechanism, insurance, and race. Discussion UR-30 occurs predominantly in moderately injured patients and is influenced by ICU and hospital LOS, discharge disposition, comorbidities, and transfusion status, underscoring its value as a trauma quality metric.