Background This study identifies the determinants of unplanned readmission after self-inflicted and non-self-inflicted major injury to inform potential readmission screening.
Method A retrospective cohort study of 11,269 individuals aged ≥15 years hospitalised for a major injury during 2013–2017 in New South Wales, Australia was conducted using linked trauma registry, hospitalisation and mortality records. Predictors of unplanned readmission up to 27 months post-injury were examined using logistic regression.
Results There were 98 (26.1%) individuals with self-inflicted injuries and 2,700 (24.8%) individuals with non-self-inflicted injuries with an unplanned readmission. Individuals with an anxiety-related disorder and a non-self-inflicted injury who were discharged home were three times more likely (OR: 3.27; 95%CI 2.28–4.69) or if they were discharged to a psychiatric facility were four times more likely (OR: 4.11; 95%CI 1.07–15.80) to be readmitted. Compared to individuals aged 15–24 years, individuals aged ≥65 years were 3 times more likely to be readmitted (OR 3.12; 95%CI 2.62–3.70). Individuals with one (OR 1.60; 95%CI 1.39–1.84) or ≥2 (OR 1.88; 95%CI 1.52–2.32) comorbidities, or who had a drug-related dependence (OR 1.88; 95%CI 1.52–2.31) were more likely to be readmitted.
Conclusions Unplanned readmission after major injury is associated with injury intent, age and comorbid health. Individuals who already experience psychological distress, such as anxiety, or who have drug-related dependence, may find that these conditions are exacerbated after injury.
Learning outcomes Screening for anxiety and drug-related dependence after major injury, accompanied by service referrals and post-discharge follow-up, has potential to prevent readmission after major injury.