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Related Experiment Videos

In-house trauma surgeons do not decrease mortality in a level I trauma center.

Gerard J Fulda1, Glen H Tinkoff, Frederick Giberson

  • 1Department of Surgery, Christina Care Health Services, Wilmington, Delaware, USA. gfulda@christianacare.org

The Journal of Trauma
|September 28, 2002
PubMed
Summary
This summary is machine-generated.

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In-house trauma surgeons did not significantly decrease mortality for severely injured patients compared to on-call surgeons. However, rapid availability (<15 minutes) of trauma surgeons is crucial for patient outcomes.

Area of Science:

  • Trauma Surgery
  • Surgical Outcomes
  • Emergency Medicine

Background:

  • The necessity of having in-house trauma surgeons versus on-call surgeons remains a subject of debate.
  • Prior research has compared these models across different institutions or time periods.
  • This study aimed to evaluate both models concurrently within a single Level I trauma center.

Purpose of the Study:

  • To assess the impact of in-house trauma surgeons on the mortality rates of severely injured patients.
  • To compare the effectiveness of in-house versus on-call trauma surgeon coverage.
  • To analyze the relationship between surgeon availability and patient outcomes.

Main Methods:

  • A retrospective review of major resuscitation records from July 1997 to November 1999.

Related Experiment Videos

  • Logistic regression analysis to identify mortality predictors based on surgeon status and response time.
  • Controlling for Injury Severity Score (ISS) and Revised Trauma Score (RTS) in the analysis.

    • Main Results:

    • No significant difference in mortality was observed between patients treated by in-house versus on-call trauma surgeons.
    • Average response times were significantly shorter for in-house surgeons (3.96 minutes) compared to on-call surgeons (14.70 minutes).
    • Neither surgeon status nor response time significantly reduced emergency department or hospital mortality, though a trend favored in-house surgeons in specific subgroups.

    Conclusions:

    • Rapid trauma surgeon availability (under 15 minutes) showed no difference in mortality between in-house and on-call models.
    • Certain patient subgroups, including those with neurological impairment, may benefit from in-house trauma surgeon care.
    • Institutions lacking immediate trauma surgeon availability may need an in-house call policy for prompt resuscitation.