@article{ref1,
title="The Volume-Outcomes Relationship for United States Level I Trauma Centers",
journal="Journal of surgical research",
year="2011",
author="Bennett, Kyla M. and Vaslef, Steven and Pappas, Theodore N. and Scarborough, John E.",
volume="167",
number="1",
pages="19-23",
abstract="BACKGROUND: Previous studies of the center volume-outcomes relationship for severe trauma care have yielded conflicting findings regarding the presence or nature of such a relationship. Few studies have confined their analysis to Level I centers. METHODS: We performed a retrospective analysis of severely injured adults treated from 2001 through 2006 in United States Level I trauma centers using data from the National Trauma Data Bank version 7.1. The post-injury in-hospital mortality rates for patients treated at high- or medium-volume Level I trauma centers were compared with the rates for patients treated at low-volume Level I centers before and after adjustment for patient demographic and injury characteristics. Subgroup comparisons were performed for those Level I centers with and without American College of Surgeons (ACS) verification of Level I designation. RESULTS: Overall, medium-volume Level I trauma centers had significantly lower mortality than low-volume centers (14.3% versus 15.6%), both before and after adjustment for patient demographic and injury characteristics. Of those trauma centers without ACS verification of Level I designation, high-volume centers had significantly greater mortality than low-volume centers. CONCLUSIONS: Our findings support the current utilization by the American College of Surgeons of minimum annual volume requirements for the verification of Level I trauma center designation, and suggest that the presence of such verification may enable Level I centers to effectively manage high volume of severely injured adult patients.<p /> <p>Language: en</p>",
language="en",
issn="0022-4804",
doi="10.1016/j.jss.2010.05.020",
url="http://dx.doi.org/10.1016/j.jss.2010.05.020"
}