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Analysis of a rural trauma program using the TRISS methodology: a three-year retrospective study
L L Karsteadt1, C L Larsen, P D Farmer
1North Coast Emergency Medical Services, Eureka, CA 95501.
The Journal of Trauma
|March 1, 1994
Summary
A rural trauma program in California significantly improved patient survival rates. This study evaluated major trauma cases, demonstrating better outcomes compared to established benchmarks.
Area of Science:
- Emergency Medicine
- Trauma Surgery
- Public Health
Background:
- Rural emergency medical services (EMS) face unique challenges in managing major trauma.
- Evaluating the impact of specialized trauma programs is crucial for improving patient outcomes in underserved areas.
Purpose of the Study:
- To assess the effectiveness of a rural trauma program in California.
- To analyze the program's impact on patient survival and outcomes.
Main Methods:
- A three-year retrospective and prospective study of 266 major trauma patients.
- Data collected included patient demographics, Trauma Scores (TS), Revised Trauma Scores (RTS), Injury Severity Scores (ISS), and Mechanism of Injury (MOI).
- TRISS methodology, z statistic, and M scores were used to evaluate patient outcomes against Major Trauma Outcome Study (MTOS) norms.
Main Results:
- The majority of patients were male (71.9%) with a mean age of 34.05.
- Blunt trauma (82.1%), primarily from motor vehicle crashes (63.8%), was the leading cause of injury.
- The study found a significant improvement in survival rates (z = -2.33, p = 0.020) compared to MTOS baseline norms.
Conclusions:
- The rural trauma program demonstrated significant effectiveness in improving patient survival.
- These findings support the implementation and expansion of similar programs in rural EMS regions.
- Optimizing trauma care in rural settings is essential for reducing mortality and morbidity.