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Among patients hospitalized with a traumatic injury, in-hospital case fatality rates for the initial hospitalization may not be an adequate measure of trauma care success because postdischarge mortality is substantial. Davidson and colleagues analyzed 1995-2008 Washington State Trauma Registry and linked death certificate data to assess the long-term mortality of 124 421 patients who were treated in a Washington State designated trauma hospital. Among the authors' findings were that 7243 patients died before and 21 045 died after hospital discharge. During the 14-year study, in-hospital mortality of Washington State trauma patients decreased from 8% to 4.9%, whereas long-term cumulative mortality rates increased from 4.7% to 7.4%. The authors reported that 16% of patients died in the 3 years following injury compared with an expected population cumulative mortality of 5.9% and reported that patients who were discharged to a skilled nursing facility had a significantly increased risk of subsequent mortality compared with patients discharged home without assistance.
This Week in JAMA . JAMA. 2011;305(10):969. doi:10.1001/jama.2011.272
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