Performance of a regional trauma network: A state-wide analysis

Area of Science:

• Trauma Surgery
• Public Health
• Health Services Research

Background:

• The Northern Ohio Trauma System (NOTS) was established in 2010 as a collaborative regional trauma network.
• NOTS comprises one Level I Trauma Center (L1TC) and multiple lower-level Trauma Centers (TCs) across various hospital systems.

Purpose of the Study:

• To evaluate the performance of the NOTS by comparing mortality rates within the NOTS region to other Ohio counties.
• To assess the impact of trauma system regionalization on patient outcomes.

Main Methods:

• Analysis of state trauma registry data for patients aged 15+ from 2006-2012.
• Comparison of mortality rates before and after NOTS establishment.
• County-level and regional analyses comparing NOTS with other L1TC regions, including subgroups for Injury Severity Score (ISS) ≥15, age ≥65, and trauma mechanism.

Main Results:

• Cuyahoga County, containing the NOTS L1TC, showed significant mortality reduction across all patient groups (p < 0.05).
• NOTS patients were older, had similar/higher ISS, and were treated more at lower-level TCs (p < 0.001).
• Regional analysis indicated lower mortality in the NOTS region for overall, geriatric, and blunt injury subgroups.

Conclusions:

• Trauma system regionalization, as implemented by NOTS, is associated with reduced patient mortality.
• The study suggests collaborative regional trauma systems are more critical than the number of L1TCs.
• Significant mortality reduction was observed in Cuyahoga County for all patient groups over time.