Analysis of a rural trauma program using the TRISS methodology: a three-year retrospective study

A three-year retrospective and prospective study was conducted in the North Coast EMS Region of California to evaluate the effectiveness of a rural trauma program and its impact on patient outcome. Two hundred sixty-six patients with major trauma were identified. Age, hospital and prehospital Trauma Scores (TS), Revised Trauma Scores (RTS), Injury Severity Scores (ISS), and Mechanism of Injury (MOI) were recorded. Patient outcomes were evaluated using TRISS methodology. In addition, the z statistic and M scores were calculated and compared with baseline Major Trauma Outcome Study (MTOS) norms. The majority of patients were male (71.9%), and the mean age was 34.05 (SD +/- 20.14). Blunt trauma accounted for the majority of injuries (82.1%) and the primary cause was motor vehicle crashes (63.8%). The z (mortality) and M statistics were -2.33 (p = 0.020) and 0.66, respectively. Thus a significant improvement in survival rates resulted compared with MTOS baseline norms.