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39 Determinants of unplanned readmission following self-inflicted and non-self-inflicted major injury
  1. Rebecca Mitchell1,
  2. Ian Harris2,
  3. Zsolt Balogh3,
  4. Kate Curtis4,
  5. Brian Burns5,6,
  6. Ian Seppelt7,
  7. Julie Brown8,
  8. Pooria Sarrami9,10,
  9. Hardeep Singh9,
  10. Jean-Frederic Levesque11,12,
  11. Michael Dinh9,13
  1. 1Australian Institute of Health Innovation, Macquarie University, Macquarie University, Australia
  2. 2Whitlam Orthopaedic Research Centre, Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Australia
  3. 3Department of Traumatology, John Hunter Hospital and University of Newcastle
  4. 4Susan Wakil School of Nursing, Faculty of Medicine and Health, University of Sydney
  5. 5Sydney Medical School, Faculty of Medicine and Health, University of Sydney
  6. 6Sydney HEMS, NSW Ambulance
  7. 7Nepean Hospital and Sydney Medical School, Faculty of Medicine and Health, University of Sydney
  8. 8The George Institute for Global Health, University of New South UK
  9. 9NSW Institute for Trauma and Injury Management (ITIM), NSW Agency for Clinical Innovation (ACI)
  10. 10South Western Sydney Clinical School, University of New South UK
  11. 11NSW Agency for Clinical Innovation (ACI)
  12. 12Centre for Primary Health Care and Equity, University of New South UK
  13. 13Sydney Medical School, the University of Sydney


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.

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