Do trauma centers improve outcome over non-trauma centers: The evaluation of regional trauma care using discharge abstract data and patient management categories

J. Stanley Smith, Louis F. Martin, Wanda W. Young, Darren P. Macioce

Research output: Contribution to journalArticle

93 Scopus citations

Abstract

Development of regional medical care systems to treat patients who sustain major accidental injuries (trauma victims) has been based on autopsy studies which demonstrate that hospitals that meet certain accepted criteria of readiness (trauma centers) can prevent needless deaths of trauma victims. However, since only autopsy data have been available from non-trauma centers, it has not previously been possible to compare morbidity data between trauma centers and non-trauma hospitals. This study examines discharge abstract data and a new patient classification system called patient management categories (PMC) which are generated from this abstract data to evaluate length of stay (LOS), complications, and death to compare morbidity and mortality data from trauma centers and non-trauma centers. Discharge abstracts for 1,332 patients with the PMC of femoral shaft fracture with operation were obtained from all hospitals in Western Pennsylvania and Maryland for 1 year. Data from trauma centers were identified and compared to non-trauma centers using the following criteria: time to OR (=£2 days vs. >2 days), age (0-12, 13-55, >55 years), associated injuries, and development of complications and death. Patients treated in trauma centers had significantly fewer complications (21% vs. 33%; p < 0.001) and lower mortality rates (p < 0.05) than those treated in non-trauma centers. Associated injuries, age, complications, and/or delay in time to OR significantly increased intensity and length of stay in both trauma and non-trauma centers. This significantly increased the cost of care provided to these patients in both types of centers. In conclusion, examination of discharge abstract data using PMCs from large databases demonstrates that trauma center care both lowers mortality and significantly decreases morbidity rates for patients who have suffered major accidental injuries.

Original languageEnglish (US)
Pages (from-to)1533-1538
Number of pages6
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume30
Issue number12
DOIs
StatePublished - Dec 1990

All Science Journal Classification (ASJC) codes

  • Surgery
  • Critical Care and Intensive Care Medicine

Fingerprint Dive into the research topics of 'Do trauma centers improve outcome over non-trauma centers: The evaluation of regional trauma care using discharge abstract data and patient management categories'. Together they form a unique fingerprint.

  • Cite this