@article{ref1,
title="The effect of trauma center verification level on traumatic brain injury outcome after implementation of the Orange Book",
journal="American journal of surgery",
year="2020",
author="Chawla-Kondal, Bhani and Sheets, Nicholas and Mahmoud, Ahmed and Ghostine, Samer and Ayutyanont, Napatkamon and Geesman, Glenn and Plurad, David S.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Previous literature demonstrates mortality discrepancies at Level II vs. Level I centers in patients with isolated Traumatic Brain Injury (TBI). Our  hypothesis is that the implementation of the 2014 version of the resources manual  (&quot;the Orange Book&quot;) is associated with an elimination of this outcome disparity. <br><br>METHODS: Utilizing the Trauma Quality Program Participant Use File for 2017, we  compared TBI outcomes at ACS Level I vs. Level II centers. <br><br>RESULTS: 39,764 records  met inclusion criteria where 25,382 (63.8%) were admitted to a Level I center. Level  I patients were younger (56.4 vs.59.1 years, p < 0.001) and less likely to have been  injured in a single level fall (39.5%vs.45.5%, p < 0.001). The incidence of severe  TBI (11.3%vs.10.3%, p < 0.001) was more common. Adjusted mortality at a Level II vs. Level I center were similar [7.8% vs. 8.4%, 0.669]. <br><br>CONCLUSIONS: Implementation of  2014 version of the ACS resources manual is associated with improved TBI associated  mortality in ACS Level II centers relative to their Level I counterparts.<p /> <p>Language: en</p>",
language="en",
issn="0002-9610",
doi="10.1016/j.amjsurg.2020.06.021",
url="http://dx.doi.org/10.1016/j.amjsurg.2020.06.021"
}