50 - POOR OUTCOMES OF PATIENTS FROM DELAYED CARE AFTER GROUND LEVEL FALLS

Objectives: Determine if those who suffer a ground level fall and have a delayed presentation to the ED greater than 24 hours after their injury have worse outcomes compared to those who suffer a ground level fall and present within 24 hours.

Methods: This study was a single institution, retrospective analysis of the Trauma Registry at JCMC between January 1, 2017, and December 31, 2021. Any adult aged eighteen years of age or older who presented to the JCMC ED after a ground level fall was included. Patients were divided into two groups based on their time to presentation post injury: less than 24 hours or greater than 24 hours. Age and gender were the patient demographics included in analysis. Outcome measures gathered from the registry included: hospital length of stay, Intensive Care Unit (ICU) length of stay, mechanical ventilation days, injury severity score, and mortality. A student’s T-test was utilized to determine the presence of significant differences in mean age, hospital length of stay (LOS), intensive care unit (ICU) LOS, total mechanical ventilation days, and injury severity score (ISS). Chi squared testing determined if there was a relationship between overall mortality, gender, and time to presentation to the emergency department.

Results: There were 4,018 patients included in the study population. Upon analysis Female patients made up 66% of the study population. Of all patients, 200, or 5%, presented to the ED greater than 24 hours post injury. Of note, male patients were more likely to be in the delayed presentation group compared to female patients (X2(1, N=4,018) =4.85, P=.028)). Those who presented greater than 24 hours post injury were younger in age (71 vs 74 years old, P= < 0.01), experienced greater hospital LOS (6 vs. 5 days, P= < 0.01), ICU LOS (5 vs. 3 days, P= < 0.01), mechanical ventilation days (13 vs. 5 days, P= < 0.01). Also noted was a significantly increased injury severity score (8 vs. 7, P= < 0.01) and mortality (X2(1, N=4,018) =4.48, P=.034) in those who presented after 24 hours.

Conclusion: Patients who suffer a ground level fall and present to the emergency department greater than 24 hours post injury are significantly more likely to be male, younger in age, experience longer hospital LOS, ICU LOS, mechanical ventilation days, injury severity score, and overall mortality.