@article{ref1,
title="Impact of a trauma network on mortality in patients with severe pelvic trauma",
journal="Annales Francaises d'Anesthesie et de Reanimation",
year="2013",
author="Bouzat, P. and Broux, C. and Ageron, François-Xavier and Gros, I. and Levrat, A. and Thouret, J-m and Thony, F. and Tonetti, J. and Payen, J-f",
volume="32",
number="12",
pages="827-832",
abstract="AIM: To evaluate the impact of a regional trauma network on intra-hospital mortality rates of patients admitted with severe pelvic trauma. STUDY: Retrospective observational study. PATIENTS: Sixty-five trauma patients with serious pelvic fracture (pelvic abbreviated injury scale [AIS] score of 3 or more). METHODS: Demographic, physiologic and biological parameters were recorded. Observed mortality rates were compared to predicted mortality according to the Trauma Revised Injury Severity Score methodology adjusted by a case mix variation model. RESULTS: Twenty-nine patients were admitted in a level I trauma centre (reference centre) and 36 in level II trauma centres (centres with interventional radiology facility and/or neurosurgery). Patients from the level I trauma centre were more severely injured than those who were admitted at the level II trauma centres (Injury Severity Score [ISS]: 30 [13-75] vs 22 [9-59]; P<0.01). Time from trauma to hospital admission was also longer in level I trauma centre (115 [50-290] min vs 90 [28-240] min, P <0.01). Observed mortality rates (14%; 95% confidence interval, 95% CI, [1-26%]) were lower than the predicted mortality (29%; 95% CI [13-44%]) in the level I trauma centre. No difference in mortality rates was found in the level II trauma centres. CONCLUSION: The regional trauma network could screen the most severely injured patients with pelvic trauma to admit them at a level I trauma centre. The observed mortality of these patients was lower than the predicted mortality despite increased time from trauma to admission.<p /> <p>Language: fr</p>",
language="fr",
issn="0750-7658",
doi="10.1016/j.annfar.2013.10.018",
url="http://dx.doi.org/10.1016/j.annfar.2013.10.018"
}