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

- Safety in admitting trauma patients to nonsurgical services is theorized.
- Propose that nonsurgical admission does not compromise trauma-related medical care.
- Nonsurgical admissions tend to have less severe injuries but more comorbidities.
- Outcome measures did not differ between admission groups.

BackgroundGiven 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.MethodsAdult 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.ResultsCompared 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.ConclusionsAs 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.