Adequacy of hospital discharge status as a measure of outcome among injured patients

Richard Mullins, N. Clay Mann, Jerris R. Hedges, William Worrall, Mark Helfand, Andrew D. Zechnich, Gregory J. Jurkovich

Research output: Contribution to journalArticle

90 Citations (Scopus)

Abstract

Context.- Crude mortality rates at the time of hospital discharge are commonly used to assess the quality of care provided to patients hospitalized following trauma. Objectives.- To evaluate the adequacy of hospital death rates as an outcome measure following trauma and to determine the influence of noninjury illness as a cause of hospital death and the frequency of postdischarge death. Design.- Retrospective cohort analyses using hospital discharge data for injured patients cross-linked to death certificate data that provided 1 year of follow-up for all patients discharged alive. Patients.- A total of 90 048 injured patients admitted to all acute care hospitals in the state of Washington from 1991 through 1993 and discharged with at least 1 diagnosis coded in the International Classification of Diseases, Ninth Revision, Clinical Modification to indicate trauma. Main Outcome Measures.- Death in the hospital and death within 30 days of hospital discharge. Results.- Among 1912 injured patients with in-hospital deaths, 825 death certificates (43%) listed a noninjury cause of death. The overall mortality rate at hospital discharge was 21.2 per 100 000 hospitalized injured patients, and was 12.1 per 100 000 for trauma deaths and 9.1 per 100 000 for those designated as nontrauma deaths. Patients with trauma-related death designations were younger (mean age, 51.5 years vs 77.9 years), had shorter lengths of stay (median stay, 2 days vs 5 days), and sustained more severe injures (P

Original languageEnglish (US)
Pages (from-to)1727-1731
Number of pages5
JournalJournal of the American Medical Association
Volume279
Issue number21
DOIs
StatePublished - Jun 3 1998

Fingerprint

Outcome Assessment (Health Care)
Wounds and Injuries
Death Certificates
Mortality
Cause of Death
State Hospitals
Quality of Health Care
International Classification of Diseases
Length of Stay
Cohort Studies

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Adequacy of hospital discharge status as a measure of outcome among injured patients. / Mullins, Richard; Mann, N. Clay; Hedges, Jerris R.; Worrall, William; Helfand, Mark; Zechnich, Andrew D.; Jurkovich, Gregory J.

In: Journal of the American Medical Association, Vol. 279, No. 21, 03.06.1998, p. 1727-1731.

Research output: Contribution to journalArticle

Mullins, Richard ; Mann, N. Clay ; Hedges, Jerris R. ; Worrall, William ; Helfand, Mark ; Zechnich, Andrew D. ; Jurkovich, Gregory J. / Adequacy of hospital discharge status as a measure of outcome among injured patients. In: Journal of the American Medical Association. 1998 ; Vol. 279, No. 21. pp. 1727-1731.
@article{42b0a7d3d7bc4d4fb1b367bc49b4d856,
title = "Adequacy of hospital discharge status as a measure of outcome among injured patients",
abstract = "Context.- Crude mortality rates at the time of hospital discharge are commonly used to assess the quality of care provided to patients hospitalized following trauma. Objectives.- To evaluate the adequacy of hospital death rates as an outcome measure following trauma and to determine the influence of noninjury illness as a cause of hospital death and the frequency of postdischarge death. Design.- Retrospective cohort analyses using hospital discharge data for injured patients cross-linked to death certificate data that provided 1 year of follow-up for all patients discharged alive. Patients.- A total of 90 048 injured patients admitted to all acute care hospitals in the state of Washington from 1991 through 1993 and discharged with at least 1 diagnosis coded in the International Classification of Diseases, Ninth Revision, Clinical Modification to indicate trauma. Main Outcome Measures.- Death in the hospital and death within 30 days of hospital discharge. Results.- Among 1912 injured patients with in-hospital deaths, 825 death certificates (43{\%}) listed a noninjury cause of death. The overall mortality rate at hospital discharge was 21.2 per 100 000 hospitalized injured patients, and was 12.1 per 100 000 for trauma deaths and 9.1 per 100 000 for those designated as nontrauma deaths. Patients with trauma-related death designations were younger (mean age, 51.5 years vs 77.9 years), had shorter lengths of stay (median stay, 2 days vs 5 days), and sustained more severe injures (P",
author = "Richard Mullins and Mann, {N. Clay} and Hedges, {Jerris R.} and William Worrall and Mark Helfand and Zechnich, {Andrew D.} and Jurkovich, {Gregory J.}",
year = "1998",
month = "6",
day = "3",
doi = "10.1001/jama.279.21.1727",
language = "English (US)",
volume = "279",
pages = "1727--1731",
journal = "JAMA - Journal of the American Medical Association",
issn = "0002-9955",
publisher = "American Medical Association",
number = "21",

}

TY - JOUR

T1 - Adequacy of hospital discharge status as a measure of outcome among injured patients

AU - Mullins, Richard

AU - Mann, N. Clay

AU - Hedges, Jerris R.

AU - Worrall, William

AU - Helfand, Mark

AU - Zechnich, Andrew D.

AU - Jurkovich, Gregory J.

PY - 1998/6/3

Y1 - 1998/6/3

N2 - Context.- Crude mortality rates at the time of hospital discharge are commonly used to assess the quality of care provided to patients hospitalized following trauma. Objectives.- To evaluate the adequacy of hospital death rates as an outcome measure following trauma and to determine the influence of noninjury illness as a cause of hospital death and the frequency of postdischarge death. Design.- Retrospective cohort analyses using hospital discharge data for injured patients cross-linked to death certificate data that provided 1 year of follow-up for all patients discharged alive. Patients.- A total of 90 048 injured patients admitted to all acute care hospitals in the state of Washington from 1991 through 1993 and discharged with at least 1 diagnosis coded in the International Classification of Diseases, Ninth Revision, Clinical Modification to indicate trauma. Main Outcome Measures.- Death in the hospital and death within 30 days of hospital discharge. Results.- Among 1912 injured patients with in-hospital deaths, 825 death certificates (43%) listed a noninjury cause of death. The overall mortality rate at hospital discharge was 21.2 per 100 000 hospitalized injured patients, and was 12.1 per 100 000 for trauma deaths and 9.1 per 100 000 for those designated as nontrauma deaths. Patients with trauma-related death designations were younger (mean age, 51.5 years vs 77.9 years), had shorter lengths of stay (median stay, 2 days vs 5 days), and sustained more severe injures (P

AB - Context.- Crude mortality rates at the time of hospital discharge are commonly used to assess the quality of care provided to patients hospitalized following trauma. Objectives.- To evaluate the adequacy of hospital death rates as an outcome measure following trauma and to determine the influence of noninjury illness as a cause of hospital death and the frequency of postdischarge death. Design.- Retrospective cohort analyses using hospital discharge data for injured patients cross-linked to death certificate data that provided 1 year of follow-up for all patients discharged alive. Patients.- A total of 90 048 injured patients admitted to all acute care hospitals in the state of Washington from 1991 through 1993 and discharged with at least 1 diagnosis coded in the International Classification of Diseases, Ninth Revision, Clinical Modification to indicate trauma. Main Outcome Measures.- Death in the hospital and death within 30 days of hospital discharge. Results.- Among 1912 injured patients with in-hospital deaths, 825 death certificates (43%) listed a noninjury cause of death. The overall mortality rate at hospital discharge was 21.2 per 100 000 hospitalized injured patients, and was 12.1 per 100 000 for trauma deaths and 9.1 per 100 000 for those designated as nontrauma deaths. Patients with trauma-related death designations were younger (mean age, 51.5 years vs 77.9 years), had shorter lengths of stay (median stay, 2 days vs 5 days), and sustained more severe injures (P

UR - http://www.scopus.com/inward/record.url?scp=0032478956&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0032478956&partnerID=8YFLogxK

U2 - 10.1001/jama.279.21.1727

DO - 10.1001/jama.279.21.1727

M3 - Article

C2 - 9624026

AN - SCOPUS:0032478956

VL - 279

SP - 1727

EP - 1731

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0002-9955

IS - 21

ER -