Outcomes and Costs of Patients Admitted to the Intensive Care Unit Following a Traumatic Injury
CCCF ePoster library. Tran A. Nov 9, 2018; 233392
Alexandre Tran
Alexandre Tran
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Abstract
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Introduction: Trauma is a leading cause of mortality, morbidity and staggering economic costs related to loss of productivity as well as medical expenses. While ICU costs are known to represent the largest single contributor of in-hospital expenses in trauma patients, little is known regarding the resource utilization breakdown and predictors of hospital and ICU costs.



Objectives: We aimed to describe the resource utilization breakdown and predictors of ICU costs among patients with traumatic injuries.



Methods: We performed a retrospective analysis of a health administrative database for patients admitted to ICU following a traumatic injury from September 2010 to December 2016. It was performed based on data from 2 ICUs within a single tertiary care hospital system. A generalized linear model was used to identify significant predictors of increasing hospital costs. Variables included for testing in the model were selected based on a priori identification of clinically important predictors.



Results: We identified 1240 distinct trauma patients admitted to ICU between September 2010 and December 2016. The mean age was 55.1 years and 47.6% of patients had an identified head injury. The in-hospital mortality was 23.3%. The mean time on mechanical ventilation was 5.1 days with a mean ICU length of stay of 8.1 days. The mean total hospital cost per patient was $55,899 CAD of which $34,673 was directly attributable to ICU costs. Direct costs with fee codes linked to the patient chart, such as lab testing, medical imaging, medications and nursing care, accounted for approximately 75% and 76% of total hospital and ICU costs respectively. Independent predictors of increased hospital costs were hospital length of stay (P < 0.0001), ICU length of stay (P < 0.0001), duration of mechanical ventilation (P = 0.029), presence of head injury (P < 0.0001) and survival to discharge (P < 0.0001).



Conclusion: Traumatic injury results in significant morbidity, mortality and hospitalization costs. Independent predictors of increased costs include hospital and ICU length of stay, duration of mechanical ventilation, head injury and survival to discharge.

 


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