Number and Type of Complications Associated With Failure to Rescue in Trauma Patients

Background: Failure to rescue (FTR) is becoming a ubiquitous metric of quality care. The aim of our study is to determine the type and number of complications associated with FTR after trauma. Methods: We reviewed the Trauma Quality Improvement Program including patients who developed complications after admission. Patients were divided as the following: “FTR” if the patient died or “rescued” if the patient did not die. Logistic regression was used to ascertain the effect of the type and number of complications on FTR. Results: A total of 25,754 patients were included with 972 identified as FTR. Logistic regression identified sepsis (odds ratio [OR] = 6.61 [4.72-9.27]), pneumonia (OR = 2.79 [2.15-3.64]), acute respiratory distress syndrome (OR = 4.6 [3.17-6.69]), and cardiovascular complications (OR = 24.22 [19.39-30.26]) as predictors of FTR. The odds ratio of FTR increased by 8.8 for every single increase in the number of complications. Conclusions: Specific types of complications increase the odds of FTR. The overall complication burden will also increase the odds of FTR linearly. Level of Evidence: Level III Prognostic.