The impact of the volume of neurotrauma experience on mortality after head injury.

The volume of neurotrauma experience and mortality after head injury were evaluated in 4667 patients admitted to 10 Level I trauma centers. The hospitals were divided into three groups based on the number of severely head-injured patients admitted each month. The mean number of patients admitted each month to Hospital Groups 1, 2, and 3 with a Glasgow Coma Scale (GCS) score > 10 was 100.0, 18.2, and 10.6. Mortality was significantly lower for patients admitted to Group 1 than for those admitted to Group 2 or 3; however, the difference between Groups 2 and 3 was not significant. The mean number of admissions with a GCS score < or = 10 was 8.3, 6.5, and 2.8, and mortality rates were 26.7 per cent, 36.5 per cent, and 41.4 per cent, respectively. Mortality for Group 1 patients was significantly lower than for those in Groups 2 or 3. Patient age also had a profound impact on survival among all hospital groups. We conclude that the volume of neurotrauma experience correlates with mortality after head injury.