Aims: Length of Stay (LOS) is an important outcome for hospitals, contributing to resource utilisation and patient flow. This study aimed to identify factors associated with LOS in older persons admitted with trauma at a major trauma centre as targets for improvement.
Methods: Using a newly established prospective database including all trauma related admissions for patients aged ≥65years over a 12-month period, univariable negative binomial logistic regression identified variables associated with LOS with p-values ≤0.1 which were then included in a multivariable regression model. Significance was taken as p-value ≤0.05.
Results: 1165 admissions with complete data and alive at discharge were included in the analysis. The median LOS was 7 (IQR=3-12) days. In the multivariable model, complications including delirium (IRR(incidence rate ratio)=1.42, 95%CI=1.25-1.62), inpatient fall (IRR=1.51, 95%CI=1.17-1.94), pneumonia (IRR=1.24, 95%CI=1.02-1.50), thromboembolism (IRR=1.47, 95%CI=1.05-2.04), blood transfusion (IRR=1.38, 95%CI=1.19-1.58) and unplanned intensive care admission (IRR=1.62, 95%CI=1.11-2.36), in addition to age (IRR=1.01, 95%CI=1.00 – 1.01), low fall mechanism (IRR=1.28, 95%CI=1.12-1.46), polypharmacy (IRR=1.27, 95%CI=1.13-1.42), dementia (IRR=1.50, 95%CI=1.24-1.80), surgery (IRR=1.64, 95%CI=1.44-1.88) and being admitted to a unit other than general medicine, trauma or orthopaedics (IRR1.30, 95%CI=1.07-1.58) were all associated with increased LOS. Female sex (IRR=0.89, 95%CI=0.80 – 0.99) and living home with others (IRR=0.89, 95%CI=0.79-0.99) or in residential care (IRR=0.39, 95%CI=0.29-0.51) were associated with decreased length of stay.
Conclusions: After controlling for available factors, inpatient complications in addition to patient and injury related factors were significantly associated with increased LOS. These may represent areas for improvement targeted at reducing LOS for older adults admitted with trauma.