Can we improve trauma mortality in a state with a voluntary trauma system

Arizona has no organized statewide trauma system. We looked at the 1997 and the 1998 Uniform Hospital Discharge Data Set (UHDDS) for the State of Arizona, and examined the trauma mortality data at both trauma hospitals and nontrauma hospitals.

All qualifying mortalities based on hospital data from 1997 through 1998 were reviewed for the State of Arizona. Trauma deaths from 32 nontrauma hospitals were examined and compared with that of 7 level 1 trauma centers within the state.

In this time period, there were 375 qualified mortalities from nontrauma centers and 761 qualified mortalities from level 1 trauma facilities. Only 29 (8%) of nontrauma hospital deaths were found to be due to motor vehicle accidents. Only 8 (4%) mortalities at nontrauma centers were due to firearms.

The data suggest that patients are arriving at the appropriate facility for definitive care despite the absence of a formal statewide trauma system.