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To describe the characteristics of major injury and identify determinants of long-term unplanned readmission and mortality after self-inflicted and non-self-inflicted injury to inform potential readmission screening. A retrospective cohort study of 11,269 individuals aged ≥ 15 years hospitalised for a major injury during 2013–2017 in New South Wales, Australia. Unplanned readmission and mortality up to 27-month post-injury were examined. Logistic regression was used to examine predictors of unplanned readmission. During the 27-month follow-up, 2700 (24.8%) individuals with non-self-inflicted and 98 (26.1%) with self-inflicted injuries had an unplanned readmission. Individuals with an anxiety-related disorder and a non-self-inflicted injury who were discharged home were three times more likely (OR: 3.27; 95%CI 2.28–4.69) or if they were discharged to a psychiatric facility were four times more likely (OR: 4.11; 95%CI 1.07–15.80) to be readmitted. Compared to individuals aged 15–24 years, individuals aged ≥ 65 years were 3 times more likely to be readmitted (OR 3.12; 95%CI 2.62–3.70). Individuals with one (OR 1.60; 95%CI 1.39–1.84) or ≥ 2 (OR 1.88; 95%CI 1.52–2.32) comorbidities, or who had a drug-related dependence (OR 1.88; 95%CI 1.52–2.31) were more likely to be readmitted. The post-discharge age-adjusted mortality rate following a self-inflicted injury (35.6%; 95%CI 29.9–41.8) was higher than for individuals with a non-self-inflicted injury (11.0%; 95%CI 10.4–11.8). Unplanned readmission after injury is associated with injury intent, age, and comorbid health. Screening for anxiety and drug-related dependence after major injury, accompanied by service referrals and post-discharge follow-up, has potential to prevent readmission.

Systematic scoping review protocol

Objective To assess the accuracy of injury-related hospitalization diagnoses by physicians in China. Methods 62,269 hospitalizations between 2014 and 2016 at a large hospital in Changsha, China were assessed. We considered three types of diagnostic errors: under-reporting, lack of cause specificity, and misclassification across injury causes. Diagnosis and coding of diseases were ascertained by professional coders based on the tenth International Classification of Disease (ICD-10). Chi square tests examined the proportion difference across subgroups of patient demographics, injury intent, and injury cause. Results The 62,269 records included 1011 injury-induced hospitalizations, but physicians’ diagnoses only reported 405 (40%) of the 1011 hospitalizations as injury-related. The proportions of under-reporting, lack of cause specificity, and misclassification errors, respectively, were 50.5%, 7.9% and 1.5%. The proportion of diagnostic errors was relatively similar across patient sex, intent of injury, and cause of injury subgroups, but varied substantially across patient age groups. Conclusion Physicians’ diagnoses frequently omitted injury-induced hospitalizations. Such errors will impact injury research and policy-making when they are undetected and uncorrected.

OBJECTIVES/GOALS: In 2016, more than 3,100 children died, and an estimated 17,000 children had non-fatal injuries, from firearms in the United States. In this study, we used hospital charges as a proxy for medical resource utilization, and compared differences in charges by intent of firearm injury among children. METHODS/STUDY POPULATION: In this cross-sectional study of the 2016 Nationwide Emergency Department Sample, we identified firearm injury cases among children aged 19 years or younger using ICD-10-CM external cause of morbidity codes. Injury intent was characterized as unintentional, assault, self-inflicted, undetermined, or due to legal intervention. We included patients treated and released from the emergency department (ED) or admitted alive to the hospital, and excluded those who were transferred or died in the ED. We used linear regressions with survey weighting to compare differences in mean healthcare charges by firearm injury intent, with and without adjustment for ED disposition. RESULTS/ANTICIPATED RESULTS: Among 12,469 cases in the weighted sample, mean age was 16.5 years, a majority were male (88.2%) and Medicaid-insured (57.8%), and 64% were discharged from the ED and 36% admitted. Injuries were 49.0% unintentional, 45.1% assault-related, and 1.8% self-inflicted. Compared to children with self-inflicted injuries (charges $115,224), children with assault-related injuries (charges $55,052; p

Purpose: To characterize helicopter transport use in a mature Midwestern trauma system located in a low population density state, examine characteristics of patients over-triaged to helicopter transport, and determine predictors of over-triage to helicopter transport. Methods: A retrospective observational study conducted using State Trauma Registry data for years 2008-2009. Study sample included patients with medical helicopter transportation. Bivariate analyses compared patients defined and not defined as over-triaged to helicopter transport. Multivariate regression was used to determine predictors of over-triage. Findings: Of the 2,084 helicopter-transported study patients, 552 (26%) were defined as over-triaged. Differences in patients based on over-triaged status included race, age, injury mechanism, injury type, and injury intent (P Language: en

Multiple sources of secondary data, including syndromic surveillance data, were used to describe leading causes of childhood injury in Wake County, NC. Injury intent and mechanism were categorized and rates were computed. We rank-ordered the top five injury mechanisms in each of three data sources and determined the top ten causes of childhood injury in Wake County. Timely and comprehensive ED visit data collected in NC DETECT proved invaluable to assessing local childhood injury causes. The ranking of childhood injury causes varied greatly between data sources, highlighting the importance of including a variety of data in a community health assessment.

(1) To examine survivors with traumatic brain injury (TBI) for symptoms of avoidance and intrusion, two dimensions of post-traumatic stress (PTS) at 6 and 12 months post-injury. (2) To identify risk factors associated with these symptoms.Prospective follow-up study.Georgia and North Carolina Model Brain Injury Systems participants (n = 198) with mild (19%), moderate (21%) and severe (60%) TBI were interviewed by telephone at 6 and 12 months post-injury. The Impact of Event Scale (IES) was used to identify intrusion and avoidance symptoms.Symptoms consistent with severe PTS increased from 11% at 6 months to 16% 12 months post-injury (p0.003). African-Americans (p0.01) and women (p0.05) reported greater symptomatology at 12 months compared to their counterparts. TBI severity and memory of the event were not associated with PTS-like symptoms. Symptoms increased over time when examined by race, injury intent, gender and age (p0.05).Regardless of severity, survivors with TBI are at risk for developing symptoms consistent with PTS. Amnesia for the injury event was not protective against developing these symptoms. African-Americans appear to be at greatest risk.