Determinants of length of hospital stay and ICU admission in traumatic patients in an Iranian hospital

Background: Trauma is a leading cause of mortality and morbidity worldwide, with developing countries facing significant challenges in managing its impact. Objectives: This study aimed to investigate trauma characteristics and the influence of factors on two primary outcomes: the length of hospital stay (LOS) and intensive care unit (ICU) admission. Methods: The study included trauma patients admitted to Shohada Hospital who met the National Trauma Registry of Iran (NTRI) inclusion criteria between 2017 and 2020. Different covariates were associated with ICU admission and LOS, and the association was assessed using regression models. Results: Out of 9,829 patients, fall was the most common trauma cause in both men (38.8%) and women (64.1%). Fallings were more prevalent among women, whereas road traffic crashes (RTCs) were more common among men (p 0.001). Quantile regressions showed significant associations between age, injury severity score (ISS), and cause of trauma with LOS. After adjusting for variables including age, gender, education, and ISS, patients injured by falls had a median LOS 20 hours shorter than those injured by RTCs (95% CI: -22.26 to -17.73, p 0.001). Univariable logistic regression results showed that the odds of ICU admission in patients with fall injuries were 2.12 times higher than in patients injured by RTCs (95% CI: 1.59 to 2.82, p 0.001). Conclusion: Most trauma cases involved men, and falls were the most common cause of trauma, which differed from the results reported by NTRI collaborating centers. Women had more fall-related injuries, while men had higher events of RTCs. Falls had a shorter LOS compared to those injured by RTCs. Key factors impacting ICU admission and LOS were age, ISS, RTC, and trauma cause.