Citation

Tinkoff GH, Reed JF, Megargel R, Alexander EL, Murphy S, Jones MS. J. Trauma 2010; 69(2): 245-252.

Affiliation

Department of Surgery, Christiana Care Health System, Newark, Delaware; Office of Emergency Services, Delaware Division of Public Health, Dover, Delaware; Bayhealth Medical Center, Kent General Hospital, Dover, Delaware; and Department of Surgery, Alfred I. DuPont Hospital for Children, Wilmington, Delaware.

Copyright

(Copyright © 2010, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0b013e3181e493b9

PMID

20699731

Abstract

BACKGROUND:: The impact of implementing an inclusive state trauma system on injury-related mortality for patients with life-threatening injuries was assessed. METHODS:: Using the state trauma registry, trauma patients evaluated in all of Delaware's acute care hospitals from 1998 to 2007 were identified. Patients were categorized by injury severity score (ISS) groups (1-9, 10-15, 16-24, and >24). Each category was analyzed by mortality and interfacility transfer rate to the Level I trauma center for each year. An analysis of the National Trauma Data Bank (NTDB) for these ISS groups and mortality was performed to provide a comparative benchmark. chi and analysis of variance were used where appropriate (p 24 group. For this group, there was an incremental mortality decrease from 45.7% (1998) to 20.5% (2007) (p 24 group managed at the Level I hospital significantly increased over the same period. CONCLUSION:: Since its inception, Delaware's trauma system, in which all acute care hospitals participate, has been associated with an incremental, significant decrease in mortality of the most critically injured patients. This decrease is more substantial than that experienced nationally as depicted within the NTDB. These findings and our evolving experience support the concept and benefits of an "inclusive" trauma system.

Language: en