TY  - JOUR
PY  - 2020//
TI  - The effect of trauma center verification level on traumatic brain injury outcome after implementation of the Orange Book
JO  - American journal of surgery
A1  - Chawla-Kondal, Bhani
A1  - Sheets, Nicholas
A1  - Mahmoud, Ahmed
A1  - Ghostine, Samer
A1  - Ayutyanont, Napatkamon
A1  - Geesman, Glenn
A1  - Plurad, David S.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - 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  ("the Orange Book") 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>
LA  - en
SN  - 0002-9610
UR  - http://dx.doi.org/10.1016/j.amjsurg.2020.06.021
ID  - ref1
ER  -