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Injury and Mortality Profiles in Level II and III Trauma Centers.

Ali Farhat1, Areg Grigorian2, Ahmed Farhat2

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Trauma center outcomes show that while Level-II trauma centers (L2TCs) have longer patient stays, the mortality risk is similar compared to Level-III trauma centers (L3TCs). This suggests comparable survival rates despite differing care levels.

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Area of Science:

  • Trauma Surgery
  • Health Services Research
  • Patient Outcomes

Background:

  • Trauma center benefits are established, with Level-I and Level-II centers well-researched.
  • Limited data exists on outcome disparities between Level-II trauma centers (L2TCs) and Level-III trauma centers (L3TCs).

Purpose of the Study:

  • To compare mortality risk for patients admitted to L2TCs versus L3TCs.
  • To test the hypothesis that L3TCs offer similar mortality risk compared to L2TCs.

Main Methods:

  • Retrospective analysis of the 2016 Trauma Quality Improvement Program (TQIP) database.
  • Comparison of adult patients (18+ years) treated at American College of Surgeons (ACS) verified L2TCs and L3TCs.

Main Results:

  • No significant difference in mortality risk was found between L2TC and L3TC patients after adjusting for mortality predictors (OR 0.46, CI 0.14-1.50).
  • L2TC patients experienced a higher mortality rate (6.0% vs 1.7%) and longer median length of stay (5.0 vs 3.5 days) compared to L3TC patients.
  • Similar outcomes were observed for myocardial infarction and cerebrovascular accident between the two trauma center levels.

Conclusions:

  • Despite longer lengths of stay at L2TCs, associated mortality risk is comparable to L3TCs.
  • These findings suggest that L3TCs provide comparable survival outcomes to L2TCs for trauma patients.