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Related Experiment Videos

Trauma center resource consumption and mortality.

Paul MacLennan1, Bryan Jones, Gerald Mcgwin

  • 1University of Alabama at Birmingham, Center for Injury Sciences, 120 Kracke Building, 1922 7th Avenue South, Birmingham, AL 35294, USA.

The American Surgeon
|February 24, 2006
PubMed
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Trauma center (TC) patient volume alone is inconsistent for predicting outcomes. TC resources, measured by density, significantly impact patient mortality, especially for penetrating injuries.

Area of Science:

  • Trauma Surgery
  • Health Services Research

Background:

  • Studies on trauma center (TC) patient volume and patient outcomes show inconsistent results.
  • TC resources may be a critical factor influencing outcomes, in addition to patient volume.

Purpose of the Study:

  • To investigate the relationship between trauma center density, patient volume, and patient mortality.
  • To determine if TC resources, in conjunction with patient volume, affect patient outcomes.

Main Methods:

  • Analysis of 131 TCs from 1994-2002.
  • Calculation of TC density (TC adult beds/patient volume) and categorization into quartiles.
  • Comparison of mortality rates across density quartiles using adjusted risk ratios (RRs) and 95% confidence intervals (CIs).

Main Results:

Related Experiment Videos

  • For penetrating injuries with Injury Severity Score (ISS) < 15, mortality was higher in low-moderate (Q2) and high-moderate (Q3) density TCs compared to high-density (Q4) TCs.
  • For penetrating injuries with ISS ≥ 15, mortality was lowest in low-density (Q1) TCs compared to high-density (Q4) TCs.
  • For blunt injuries, mortality was similar between low-density (Q1) and high-density (Q4) TCs, but elevated in moderate-density TCs.

Conclusions:

  • TC density, reflecting resource availability relative to patient volume, influences patient mortality.
  • Low-density TCs showed decreased overall and penetrating injury mortality, suggesting resource adequacy.
  • Further research with enhanced resource measurements is needed to fully elucidate the interplay between patient volume, resources, and mortality.