@article{ref1,
title="A contemporary analysis of the effect of trauma center verification level on mortality in severe injury",
journal="American surgeon",
year="2021",
author="Plurad, David S. and Geesman, Glenn and Sheets, Nicholas W. and Chawla-Kondal, Bhani and Ayutyanont, Napatakamon and Mahmoud, Ahmed",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Literature demonstrates increased mortality for the severely injured at a Level II vs. Level I center. Our objective is to reevaluate the impact of trauma center verification level on mortality for patients with an Injury Severity Score (ISS) > 15 utilizing more contemporary data. We hypothesize that there would be no mortality discrepancy. STUDY DESIGN: Utilizing the ACS Trauma Quality Program Participant Use File admission year 2017, we identified severely injured (ISS >15) adult (age >15 years) patients treated at an ACS-verified Level I or Level II center. We excluded patients who underwent interfacility transfer. Logistic regression was performed to determine adjusted associations with mortality. <br><br>RESULTS: There were 63 518 patients included, where 43 680 (68.8%) were treated at a Level I center and 19 838 (31.2%) at a Level II. Male gender (70.1%) and blunt injuries (92.0%) predominated. Level I admissions had a higher mean ISS [23.8 (±8.5) vs. 22.9 (±7.8), <.001], while Level II patients were older [mean age (y) 52.3 (±21.6) vs. 48.6 (±21.0), <.001] with multiple comorbidities (37.7% vs. 34.9%, <.001). Adjusted mortality between Level I and II centers was similar (12.0% vs. 11.8%,.570). <br><br>CONCLUSIONS: Despite previous findings, mortality outcomes are similar for severely injured patients treated at a Level I vs. Level II center. We theorize that this relates to mandated Level II resourcing as defined by an updated American College of Surgeons verification process.<p /> <p>Language: en</p>",
language="en",
issn="0003-1348",
doi="10.1177/00031348211023437",
url="http://dx.doi.org/10.1177/00031348211023437"
}