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Change in trauma level designation associated with improved patient survival
Date:1/21/2008

Death rates among patients admitted to a Colorado trauma center appeared to decrease after the centers designation was upgraded, according to a report in the January issue of Archives of Surgery, one of the JAMA/Archives journals.

Trauma centers are accredited through the American College of Surgeons, according to background information in the article. Level designations are based on factors such as surgeon and nurse availability, protocols and research. Level 1 is the highest level of trauma center and most studies report improvements in survival and outcomes for patients admitted to these centers as compared with lower-level centers and non-trauma centers, although some have found no difference between level 1 and level 2 centers.

The trauma center at Swedish Medical Centera community hospital in Englewood, Colo.was upgraded from level 2 to level 1 in 2002. Kristin Scarborough, B.S., and colleagues at the hospital studied all 17,413 trauma patients consecutively admitted to the trauma center between 1998 and 2007. The researchers compared death rates of the 9,511 patients admitted when the center was designated level 2 (Jan. 1, 1998, to Dec. 31, 2002) to those of the 7,902 patients admitted after the upgrade to level 1 (Jan. 1, 2003, to March 31, 2007).

After adjusting for several other factorsincluding age, sex, injury severity, low blood pressure on hospital admission, breathing rate and co-occurring illnesses3.48 percent of patients admitted during level 2 designation died, compared with 2.5 percent of those admitted during level 1 designation. Among severely injured patients, 14.11 percent of those admitted during the level 2 designation died, compared with 8.99 percent of those admitted during level 1 designation.

Patients admitted during a level 1 designation with a severe head, chest or abdominal or pelvic injury diagnosis had a significant decrease in mortality [death] (9.96 percent vs. 14.51 percent, 7.14 percent
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Contact: Julie Lonborg
303-826-7170
JAMA and Archives Journals
Source:Eurekalert

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