J. Parreco1, A. Payson1, S. Scurci1, J. Tashiro1, J. Sola1 1University Of Miami,Miami, FL, USA
Introduction:
Previous studies have shown that readmission for mental disorders and diseases represents a significant burden after trauma that is treatable as an outpatient. The purpose of this study was to elucidate the risk factors for mental disorders and diseases after trauma that require readmission.
Methods:
The Nationwide Readmission Database (NRD) was queried for all patients with nonelective admissions in 2013 with primary or secondary diagnoses of trauma and with nonelective readmissions within 30-days. Multivariate logistic regression identified risk factors for readmission with a major diagnostic category of mental disorders and diseases. The diagnoses on readmission were evaluated and the total cost of readmissions was calculated.
Results:
During the study period, there were 47,913 patients with readmissions within 30 days after admission for trauma and 1,746 (3.6%) of these readmissions were for mental disorders and diseases. The estimated total cost of 30-day readmissions for mental disorders and diseases was $15,074,957.59 with a nationwide weighted total cost of $32,354,234.43. The strongest predictors for readmission for mental disorders and disease after trauma were penetrating trauma (OR 3.60, p<0.001, 95% CI 3.12 to 4.16), age 13 to 17 (OR 2.47, p<0.001, 95% CI 1.87 to 3.28) and primary expected payer medicare or medicaid (OR 1.86, p<0.001, 95% CI 1.65 to 2.08). The most common primary diagnoses on readmission for mental disorders and diseases after trauma were unspecified psychosis (139, 8.0%) and unspecified schizoaffective disorder (119, 6.8%). While the most common primary diagnosis for all other patients were unspecified septicemia (3,279, 7.1%) and unspecified pneumonia (1,545, 3.3%).
Conclusion:
Penetrating trauma and teenage are significant risk factors for readmission for mental diseases and disorders after trauma. Further research needs to be conducted to determine the most effective methods to treat individuals with these risk factors.
