“Discharge Against Medical Advice” is Higher in Intentional Brain Injury Cases

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Discharge Against Medical Advice (DAMA) is associated with poor outcome, frequent readmission, higher mortality, and increased risk of psychiatric and medical complications. Research has shown that head injury is highly correlated with DAMA.

A recent review of past research has looked more specifically at the relationship with DAMA and traumatic brain injury. Researchers found that DAMA was more frequent in cases of intentional traumatic brain injury. Intentional brain injuries can occur because of a suicide attempt, as well as antisocial, aggressive and disruptive behaviors. DAMA was also associated with younger age (25-34) and drug or alcohol abuse.

Knowing the characteristics of patients at high risk for DAMA can help hospital staff implement prevention policies, limit DAMA occurrence, and help protect vulnerable patients from a potentially negative outcome.

Kim H, Colantonio A, Bayley M, & Dawson D. Discharge Against Medical Advice after traumatic brain injury: Is intentional injury a predictor? The Journal of Trauma Injury, Infection, and Critical Care. (September 2011).