TABLE 4.
Risk of Mortality for Trauma Patients Discharged to Skilled Nursing Facilities
| Adjusted HR (95% CI) | |||
|---|---|---|---|
| Trauma | Surgical | CVA | |
| Age group, yr | |||
| <65 | 1 (reference) | 1 (reference) | 1 (reference) |
| 65–74 | 1.33 (1.17–1.51) | 1.12 (1.08–1.16) | 1.50 (1.24–1.82) |
| 75–84 | 1.18 (1.04–1.34) | 1.15 (1.11–1.19) | 1.77 (1.47–2.13) |
| ≥85 | 1.77 (1.56–2.01) | 1.37 (1.32–1.43) | 2.91 (2.41–3.50) |
| Male sex | 1.85 (1.78–1.92) | 1.31 (1.30–1.33) | 1.34 (1.26–1.42) |
| Comorbidity Index | |||
| 0 | 1 (reference) | 1 (reference) | 1 (reference) |
| 1 | 1.65 (1.52–1.78) | 1.57 (1.52–1.62) | 1.15 (0.95–1.38) |
| 2 | 2.57 (2.35–2.80) | 2.33 (2.24–2.41) | 1.43 (1.18–1.73) |
| ≥3 | 3.31 (2.67–4.11) | 2.91 (2.66–3.19) | 2.07 (1.64–2.63) |
| Procedure type | |||
| Neurosurgical | — | 2.00 (1.86–2.17) | — |
| Head and neck | — | 2.16 (1.99–2.35) | — |
| Cardiothoracic | — | 2.17 (2.02–2.33) | — |
| Abdominopelvic | — | 2.17 (2.03–2.33) | — |
| Orthopedic | — | 0.78 (0.73–0.84 | — |
| Spine | — | 0.99 (0.88–1.13) | — |
| Vascular | — | 2.35 (2.19–2.52) | — |
| Endovascular | — | 1.76 (1.60–1.94) | — |
| Skin and soft tissue | — | 1.73 (1.63–1.84) | — |
| Nonelective admission | — | 1.88 (1.84–1.93) | — |
| Max head ICSSS score | 1.01 (0.89–1.13) | — | — |
| Cognitive function | |||
| Independent | 1 (reference) | 1 (reference) | 1 (reference) |
| Modified independence | 1.61 (1.54–1.68) | 1.44 (1.41–1.47) | 1.28 (1.18–1.39) |
| Moderately impaired | 2.43 (2.33–2.54) | 1.77 (1.73–1.82) | 1.84 (1.70–1.99) |
| Severely impaired | 3.71 (3.42–4.02) | 2.64 (2.51–2.77) | 3.39 (3.02–3.82) |
| Length of stay (d) | 1.01 (1.01–1.01) | 1.01 (1.01–1.01) | 1.00 (0.99–1.01) |
| ICU stay | 1.29 (1.24–1.34) | 1.01 (0.99–1.03) | 1.05 (0.98–1.12) |
| Transfusion | 0.93 (0.86–1.00) | 0.97 (0.92–1.02) | — |
| MDS-ADL at SNF admission | |||
| 0 | 1 (reference) | 1 (reference) | 1 (reference) |
| 1 | 1.18 (0.68–2.02) | 1.09 (0.97–1.24) | 1.17 (0.74–1.84) |
| 2 | 1.43 (0.88–2.31) | 1.32 (1.19–1.47) | 1.39 (0.92–2.09) |
| 3 | 1.58 (0.98–2.55) | 1.61 (1.45–1.79) | 1.82 (1.20–2.76) |
| 4 | 2.08 (1.29–3.36) | 1.97 (1.77–2.18) | 2.22 (1.47–3.36) |
| 5 | 2.62 (1.63–4.23) | 2.75 (2.48–3.05) | 2.86 (1.889–4.31) |
| 6 | 4.44 (2.73–7.21) | 3.59 (3.22–4.01) | 4.80 (3.16–7.30) |
| PPN/TPN | 1.11 (1.06–1.17) | 1.14 (1.11–1.73) | 1.20 (1.09–1.32) |
| Tube feeds | 0.99 (0.86–1.12) | 1.00 (0.92–1.08) | 1.00 (0.86–1.14) |
| Pressure ulcers | 1.57 (1.52–1.64) | 1.65 (1.62–1.69) | 1.40 (1.33–1.48) |
ICISS indicates ICD-9–Based Injury Severity Score; MDS-ADL, Minimum Data Set Activities of Daily Living Score; PPN, partial parenteral nutrition; TPN, total parenteral nutrition.