Citation

McKenney MG, Livingstone AS, Schulman C, Stahl K, Lineen E, Namias N, Augenstein J. J. Am. Coll. Surg. 2009; 208(5): 750-3; discussion 753-4.

Affiliation

DeWitt Daughtry Family Department of Surgery, University of Miami, Miller School of Medicine, Miami, FL 33101, USA. mark@miami.edu

Copyright

(Copyright © 2009, American College of Surgeons, Publisher Elsevier Publishing)

DOI

10.1016/j.jamcollsurg.2009.01.036

PMID

19476829

Abstract

BACKGROUND: Trauma centers have been created to bring traumatized patients together with experienced surgeons. We reviewed our outcomes to determine if mortality rates for high Injury Severity Scores (>or= 35) correlate with surgeon experience at our trauma center. STUDY DESIGN: Using our prospectively collected database, we compared our results with mean mortality for high-volume American College of Surgeon-certified trauma centers reporting to the National Trauma Data Bank. Mortality rates for our 11 trauma surgeons were correlated with years of experience as faculty surgeons at our institution during a 2-year period. Statistical analysis was done with chi-square or weighted linear regression; significance was defined as p < 0.05. RESULTS: Our trauma center mortality rates were significantly below the mean rates of National Trauma Data Bank at all levels of injury (chi-square, p < 0.05). Despite this success, there was a significant correlation between years of experience as a surgeon at our institution and improved outcomes for patients with an Injury Severity Score >or= 35 (weighted linear regression, p < 0.05). It took, on average, 7.9 years of experience at our trauma center to reach benchmark mortality rates. CONCLUSIONS: Mortality rates for severely injured patients correlate significantly with surgeon experience at our institution. The training process does not end with fellowship or surgical residency, and surgeons new to an institution should be closely monitored and mentored to minimize mortality rates of severely injured patients. Even at a very high volume trauma center with overall results substantially better than mean expected survival, we can demonstrate that experience makes a difference.

Language: en