Introduction: Military medical care encompasses domains such as the long-term prognosis, morbidity, and quality of life of survivors after discharge from the hospital. The identification factors affecting hospitalization and readmissions are crucial in military settings. The study aimed to assess rates and causes of readmissions in military casualties.
Methods: We included 775 military personnel with combat-related injuries from September 2014 to October 2019. We determined readmissions if they occurred within one year since the date of discharge from the index admission. The data was included regarding the pattern and mechanism of injury, Abbreviated Injury Scale (AIS), injury severity score (ISS), primary and subsequent treatments and procedures, experienced side effects, source of admission, hospital care unit, and the length of stay in the hospital.
Results: The mean age of the patients was 27.99±7.55 years. The great majority of the investigated combat-related injuries were penetrating (N=639, 82.5%), followed by blunt (N=97, 12.5%). The most injured part of the body was the extremities (N=360, 46.5%), followed by the head and neck (N=175, 22.6%) and the abdomen and pelvis (N=106, 13.7%). The most common reason for the readmission event number 1-7 was overall wound infection. The average length of hospitalization during the index admission was 9.48±12.07 days. There was a significant relationship between multiple readmissions and total readmission days and LOS, max AIS, ISS, side effects, and blood transfusion(P<0.001 for all the variables). Among the variables influencing multiple readmissions, ISS>24 led to the highest risk.
Conclusion: A longer LOS within the index admission and its associated factors put patients at risk of multiple and longer readmission events in the future. The outcomes imply that patients with more severe injuries may require high-quality care for longer durations as part of the initial hospital inpatient stay, and this may motivate more effective management of combat-related injuries and the associated medical costs.