Determinants of Discharge Disposition, Complications and Resource Needs in Adult Brachial Plexus Injury Patients

Introduction: Brachial plexus injuries in adults often lead to profound impairment and substantial healthcare demands. Despite their serious impact, key prognostic factors for inpatient outcomes remain understudied. We seek to address this paucity by examining predictors of discharge disposition, complications, and resource use in hospitalized adults with brachial plexus injuries to inform more tailored care approaches.

Methods: We examined a cohort of 2,292 adult patients admitted to the hospital with brachial plexus injuries, sourced from the American College of Surgeons Trauma Quality Program database, covering the years 2019 to 2021. Patients were stratified into three age groups (18–39, 40–69, and ≥70 years), with demographic, clinical, and injury characteristics compared across groups. Multivariable logistic regression assessed predictors of home discharge, complications, and intensive care unit (ICU) admission, while linear regression identified factors associated with hospital length of stay. All analyses were performed in Python 3.7 in Google Colab.

Results: Of 2,292 patients, most were male (77.1%) with a mean age of 38.7 years. Older age groups (≥40 years) had higher rates of discharge to institutional care and complications (p < 0.001). Self-pay status increased odds of discharge home (OR 1.9, p < 0.001), while Medicare/Medicaid reduced it (OR 0.7, p = 0.013). ICU admission was strongly associated with assault injuries (OR 2.9, p < 0.001) and severe head injury (GCS 3–8, OR 15.4, p < 0.001). Hospital length of stay increased with age, female sex, and Injury Severity Score, with specific injury sites further influencing duration.

Conclusion : Factors such as age, insurance type, injury mechanism, and severity play a key role in discharge outcomes, complication rates, hospital length of stay, and need for ICU admission in adult brachial plexus injury patients. These findings emphasize the importance of tailored, efficient care strategies to enhance patient outcomes and resource use.