Within three years after hospital discharge, a "significant excess mortality rate" of 16% of trauma patients had died, and for those discharged to a skilled nursing facility, the mortality rate was 34%, no matter their age.
Nearly 10% of the patients died within the first year after discharge.
By comparison, the expected mortality of the general population, adjusted for age and sex, was 6% after three years.
Those are findings from a report looking back at 124,421 patients treated at 78 trauma hospitals in Washington State between 1995 and 2008, perhaps the largest study of its kind to look at trauma mortality after hospital discharge.
"Our results indicate that skilled nursing facility discharge status may at least be a marker for significantly higher risk of subsequent mortality and may be the focus for future research and intervention, especially in the age group of 31-to-80 year olds," wrote principal author Giana H. Davidson, MD, of Harborview Injury Prevention and Research Center in Seattle and colleagues.
"Despite increases in federal regulations intended to improve skilled nursing facility care, there has been insufficient impact on quality or public reputation," she wrote. "Further investigation is needed to determine if more health clinician oversight, funding, or rehabilitation therapy is needed to improve the care of patients at skilled nursing facilities following discharge for injury."