Is it safe to admit patients with acute injuries to nonsurgical services? A retrospective review.

Link to article at PubMed

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Is it safe to admit patients with acute injuries to nonsurgical services? A retrospective review.

Am J Surg. 2017 Jun;213(6):1098-1103

Authors: Tutunjian AM, Bugaev N, Breeze JL, Arabian SS, Rabinovici R

BACKGROUND: Given potential safety risks when admitting injured patients to nonsurgical services (NSS), the American College of Surgeons mandates trauma centers justification. However, evidence supporting this requirement is lacking.
METHODS: Adult patients cleared for admission to a NSS at a level 1 trauma center between 2012 and 2014 were retrospectively reviewed. Patient demographic, injury, and outcome characteristics were compared between nonsurgical (NSA) and surgical admission patients and analyzed for predictive value.
RESULTS: Compared with surgical admission patients, NSA patients were significantly older, had a higher number of comorbidities and/or patient and a lower Injury Severity Score, while hospital length of stay, complications, and missed injury and adjusted mortality rates were similar. NSA did not predict mortality whereas increased age, increased Injury Severity Score, and number of comorbidities and/or patient did.
CONCLUSIONS: As all complications and mortalities were unrelated to injuries per se, admission to a NSS, after protocoled clearance by a trauma or Emergency Department attending, appears to be safe.

PMID: 27427295 [PubMed - indexed for MEDLINE]

One Comment

  1. Admitting neuro, trauma, and gen surg to hospitalist services is the norm at many community hospitals. Clear delineation of responsibilities needs to be established. I have helped to defend many hospitalists from lawsuits on cases where they are attending of record on post-op patients that die of surgical complications. The hospitalist is viewed as ‘Captain of the Ship’, but is not in command.

    I am going to refer to myself as an NSS agent from now on.

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