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1 in 3 Trauma Patients Discharged to Nursing Homes Die Within Three Years

Cheryl Clark, for HealthLeaders Media, March 9, 2011

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."

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4 comments on "Trauma Patient Mortality Soars After Discharge"


A Nursing Perspective (3/9/2011 at 9:41 PM)
Having worked in level II trauma as a bedside RN in ICU and, later, as a discharge planner, this information as presented seems to reflect a ridiculous study that must have some type of ulterior [$] motive for that particular spin. The majority, if not all, of trauma patients who are so damaged that they require long term custodial SNF care of greater than 3 years are the severely brain injured patients who are unable to interact with their environment, are on tube feedings and long term trach care that can almost never be managed in the home. They are very high risk for mortality and are already under the umbrella of significant morbidity.

Tim Tarpey (3/9/2011 at 10:41 AM)
I supspect that mortality rates for those who enter the trauma center are greater than those who enter the walk-in clinic at the same hospital. Does that mean that the trauma center provides a lower quality of care than the walk-in clinic? And I suspect that patients discharged from a trauma center to an assisted living facility, to a home health agency, or any other level of care have a higher mortality rate than those who enter that same level of care without the trauma.

Laurie Hilyard RN, MSN (3/9/2011 at 9:43 AM)
Did it occur to anyone that those discharged to a skilled nursing facility are more physically compromised than those discharged to lesser care? Unless discharge destinations were randomized, comparing survival rates at a SNF to survival rates in less intense care settings is comparing apples to rocks.