J. Parreco1, T. L. Zakrison1, A. D. Badilla1, R. Rattan1 1University Of Miami,Miami, FL, USA
Introduction:
No nationally representative studies of motor vehicle collision reinjury have tracked readmission across different hospitals, having been previously limited to single hospitals. The purpose of this study was to perform the first nationwide analysis of risk factors for motor vehicle collision reinjury and readmission, including to different hospitals, among non-motorcycle and motorcycle collisions.
Methods:
The Nationwide Readmissions Database for 2013-2014 was queried for all admissions involving motor vehicle collisions. Survey weights were used to provide national estimates. Reinjury and all-cause readmission were identified. Multivariable logistic regression was used to identify risk factors.
Results:
In the 399,763 patients admitted during the study period index admission mortality rate was 2.8%, 1-year readmission rate was 10.1%, and 1-year reinjury rate was 0.85%. Motorcycles were involved in 17.7% of collisions and had a higher reinjury rate (0.99% vs 0.82%, p<0.01), and had higher median admission cost ($15,014 [$8,650-$29,559] vs $12,803 [$7,356-$25,026], p<0.01). After controlling for confounding factors through multivariable logistic regression, motorcycle collision was associated with an increased risk for reinjury (OR 1.19, p<0.01) compared to non-motorcycle collisions. Risk factors for reinjury included: leaving against medical advice (OR 2.26, p<0.01), age 25-41 (OR 1.47, p<0.01), and ISS > 15 (OR 1.32, p<0.01). Protective factors included: admission to large (OR 0.75, p<0.01) or medium-sized hospitals (OR 0.82, p=0.01) and private insurance (OR 0.80, p<0.01).
Conclusions:
This is the first nationwide study representing the largest evaluation of readmission and reinjury after motor vehicle collision, including readmission to different hospitals. Motorcyclists have higher reinjury rates. The identified risk factors offer areas for further study in injury and reinjury prevention.