TY  - BOOK
AU  - Cho, Brian H
AU  - Giladi, Aviram M
AU  - Sanghavi, Kavya K
AU  - Shipp, Michael M
TI  - The Curtis Hand Injury Matrix Score: Determining the Need for Specialized Upper Extremity Care
SN  - 0363-5023
PY  - 2022///
KW  - *Arm Injuries
KW  - *Hand Injuries
KW  - Arm Injuries/di [Diagnosis]
KW  - Arm Injuries/su [Surgery]
KW  - Hand Injuries/su [Surgery]
KW  - Hand/su [Surgery]
KW  - Humans
KW  - Injury Severity Score
KW  - Length of Stay
KW  - Retrospective Studies
KW  - Upper Extremity/su [Surgery]
KW  - Curtis National Hand Center
KW  - Journal Article
N2  - CONCLUSIONS: The CHIM score provides a framework to catalog the care and resources required when covering specialized hand and upper extremity calls and accepting transfers. This clinical validation supports considering broader use; METHODS: We identified all hand and upper extremity emergency room visits at our institution in 2018 and 2019. On initial evaluation, our institution's hand surgery team assigned each patient an alphanumeric score with a number (1-5) and letter (A-H) corresponding to injury severity and pathology, respectively. Patients were divided into 5 groups (1-5) with lower scores indicating greater severity. We compared age, LOS, discharge disposition, procedure location, transfer status, and arrival mode between groups and assessed the relationships between matrix scores and discharge disposition, procedure performed, and LOS; PURPOSE: Given the limited impact of transfer guidelines and the lack of comparative metrics for upper extremity trauma, we introduced the Curtis Hand Injury Matrix (CHIM) score to evaluate upper extremity injury acuity from the specialist perspective. Our goal was to evaluate the CHIM score as an indicator of complexity and specialist need by correlating the score with arrival mode, length of stay (LOS), discharge disposition, and procedure location; RESULTS: There were 3,822 patients that accounted for 4,026 upper extremity evaluations. There were significant differences in LOS, discharge dispositions, procedure locations, transfer status, and arrival modes between groups. Patients with more severe scores had higher rates of admission and more operating room procedures. Higher percentages of patients who arrived via helicopter, ambulance, or transfer had more severe scores. Patients with more severe scores were significantly more likely to have a procedure, hospital admission, and longer hospital stay; TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV. Copyright (c) 2021 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved
UR  - https://dx.doi.org/10.1016/j.jhsa.2021.07.034
ER  -