A Contemporary Analysis of Delayed Diagnoses After Traumatic Injury : The Role of Operative Therapy

Am Surg. 2021 Mar;87(3):384-389. doi: 10.1177/0003134820951458. Epub 2020 Sep 29.

Abstract

Background: Factors associated with delayed injury diagnosis (DID) have been examined, but incompletely researched.

Methods: We evaluated demographics, mechanism, and measures of mental status and injury severity among 10 years' worth of adult trauma patients at our center for association with DID in a multivariable regression model. Descriptions of DID injuries were reviewed to highlight characteristics of these injuries.

Results: We included 13 509 patients, 89 (0.7%) of whom had a recognized DID. In regression analysis, ISS (OR 1.04 per point, 95% CI 1.02-1.06) and number of injuries (OR 1.08 per injury, 95% CI 1.04-1.11) were associated with DID. Operative patients had twice the odds of DID (OR 2.02, 95% CI 1.18-3.44). The most common category of DID was orthopedic extremity injury (22/89).

Conclusion: DID is associated with injury severity and operative intervention. This suggests that the presence of an injury requiring operation may distract the trauma team from additional injuries.

Keywords: delayed diagnosis; outcomes; performance improvement; quality of care.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Delayed Diagnosis / statistics & numerical data*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Quality Assurance, Health Care
  • Retrospective Studies
  • Trauma Severity Indices
  • Wounds and Injuries / diagnosis*
  • Wounds and Injuries / surgery
  • Young Adult