BACKGROUND: The purpose of this study was to evaluate the impact of five trauma center characteristics on survival outcome in nine serious injury categories. METHODS: A retrospective analysis of prospectively collected data from 1992 to 1996 on patients older than 14 years of age from 24 accredited trauma centers in Pennsylvania was performed. Trauma center characteristics selected for evaluation were level of accreditation, volume of trauma admissions, presence of in-house trauma surgeons, presence of a surgical residency program, and presence of an on-site medical school. Each of these characteristics was evaluated to determine its impact on survival in the selected serious injuries. A logistic regression model was then created to evaluate the most seriously injured patients as defined by A Severity Characterization of Trauma score of < 0.50. On the basis of the logistic regression model, odd ratios were calculated treating low volume as a significant risk factor for mortality. RESULTS: Of the 88,723 patients meeting registry criteria, 13,942 met the serious injury criteria. Independent analysis suggested that accreditation was beneficial regardless of level, volume of patients treated had a direct impact on survival outcome, and the presence of a surgical residency program may confer survival benefit. Of the 13,942 patients with serious injuries, those with A Severity Characterization of Trauma score of < 0.5 were selected for evaluation by logistic regression (n = 3,562). The logistic regression model, however, showed that only volume of patients treated had a consistent association with improved survival. Odds ratio analysis revealed low volume as a significant risk factor for mortality in seven of the nine injuries studied. CONCLUSION: In this analysis, only volume of patients treated had a direct impact on survival outcome. Accreditation, regardless of level, appears to be beneficial.
BACKGROUND: The purpose of this study was to evaluate the impact of five trauma center characteristics on survival outcome in nine serious injury categories. METHODS: A retrospective analysis of prospectively collected data from 1992 to 1996 on patients older than 14 years of age from 24 accredited trauma centers in Pennsylvania was performed. Trauma center characteristics selected for evaluation were level of accreditation, volume of trauma admissions, presence of in-house trauma surgeons, presence of a surgical residency program, and presence of an on-site medical school. Each of these characteristics was evaluated to determine its impact on survival in the selected serious injuries. A logistic regression model was then created to evaluate the most seriously injured patients as defined by A Severity Characterization of Trauma score of < 0.50. On the basis of the logistic regression model, odd ratios were calculated treating low volume as a significant risk factor for mortality. RESULTS: Of the 88,723 patients meeting registry criteria, 13,942 met the serious injury criteria. Independent analysis suggested that accreditation was beneficial regardless of level, volume of patients treated had a direct impact on survival outcome, and the presence of a surgical residency program may confer survival benefit. Of the 13,942 patients with serious injuries, those with A Severity Characterization of Trauma score of < 0.5 were selected for evaluation by logistic regression (n = 3,562). The logistic regression model, however, showed that only volume of patients treated had a consistent association with improved survival. Odds ratio analysis revealed low volume as a significant risk factor for mortality in seven of the nine injuries studied. CONCLUSION: In this analysis, only volume of patients treated had a direct impact on survival outcome. Accreditation, regardless of level, appears to be beneficial.
Authors: Douglas J Wiebe; Daniel N Holena; M Kit Delgado; Nathan McWilliams; Juliet Altenburg; Brendan G Carr Journal: Am Surg Date: 2017-05-01 Impact factor: 0.688
Authors: Benjamin Kautza; Hernando Gomez; Daniel Escobar; Catherine Corey; Bilal Ataya; Jason Luciano; Ana Maria Botero; Lisa Gordon; John Brumfield; Silvia Martinez; Andre Holder; Olufunmilayo Ogundele; Michael Pinsky; Sruti Shiva; Brian S Zuckerbraun Journal: Nitric Oxide Date: 2015-09-26 Impact factor: 4.427
Authors: Corinne Bunn; Sujay Kulshrestha; Bianca Di Chiaro; Uma Maduekwe; Zaid M Abdelsattar; Marshall S Baker; Fred A Luchette; Sonya Agnew Journal: J Am Coll Surg Date: 2021-04-20 Impact factor: 6.532
Authors: M T Zacher; K-G Kanz; M Hanschen; S Häberle; M van Griensven; R Lefering; V Bühren; P Biberthaler; S Huber-Wagner Journal: Br J Surg Date: 2015-07-07 Impact factor: 6.939
Authors: Elisabeth Maria Hoogervorst; Eduard Ferdinand van Beeck; Johan Carel Goslings; Pieter Dirk Bezemer; Joost Jan Laurens Marie Bierens Journal: BMC Health Serv Res Date: 2013-03-03 Impact factor: 2.655