CENTER FOR TRAUMA SURVIVORSHIP IMPROVES POST-DISCHARGE FOLLOW-UP AND RETENTION

• Published in: The journal of trauma and acute care surgery
• Main Authors: Goldstein, Carma, Gore, Amy, La Bagnara, Susan, Jacniacka-Soto, Ilona E, Sieck, Derrick, Yonclas, Peter, Livingston, David H
• Format: Journal Article
• Language: English
• Published: United States 08.04.2022
• ISSN: 2163-0763

Although the need for high-level care persists post-discharge, severely injured trauma survivors have historically poor adherence to follow-up. We hypothesized that a dedicated Center for Trauma Survivorship (CTS) improves follow-up and facilitates post-discharge specialty care. Retrospective study of "CTS eligible" trauma patients before (Jan - Dec 2017) and after (Jan - Dec 2019) creation of the CTS. Patients with an ICU stay ≥2 days or a New Injury Severity Score ≥ 16 are CTS eligible. The before (PRE) cohort was followed through Dec 2018 and the after (CTS) cohort through Dec 2020. Primary outcome was follow-up within the hospital system exclusive of mental health and rehabilitative therapy appointments. Secondary outcomes include post-discharge surgical procedures and specialty-specific follow-up. There were no significant differences in demographics or hospital duration in the PRE (n = 177) and CTS (n = 119) cohorts. Of the CTS group, 91% presented for outpatient follow-up within the hospital system, compared to 73% in the Pre group (p < 0.001). In the PRE cohort, only 39% were seen by the trauma service compared to 62% in the CTS cohort (p < 0.001). CTS patients also had increased follow-up with other providers (80% vs 65%; p = 0.006). Notably, 33% of CTS patients had additional surgery compared to only 20% in the PRE group (p = 0.011). CTS patients had over 20% more outpatient visits (1,280 vs 1,006 visits). Despite the follow-up period for the CTS cohort occurring during the peak of the COVID-19 pandemic, limiting availability of outpatient services, our CTS significantly improved follow-up with trauma providers, as well as with other specialties. The CTS patients also underwent significantly more secondary operations. These data demonstrate that creation of a CTS can improve the post-discharge care of severely injured trauma survivors, allowing for care coordination within the healthcare system, retaining patients, generating revenue and providing needed follow-up care. Therapeutic, Level IV.