TY - JOUR PY - 2021// TI - Injury and mortality profiles in Level II and III trauma centers JO - American surgeon A1 - Farhat, Ali A1 - Grigorian, Areg A1 - Farhat, Ahmed A1 - Chin, Theresa L. A1 - Donnelly, Megan A1 - Dolich, Matthew A1 - Kuza, Catherine M. A1 - Lekawa, Michael A1 - Nahmias, Jeffry SP - ePub EP - ePub VL - ePub IS - ePub N2 - BACKGROUND: While the benefit of admission to trauma centers compared to non-trauma centers is well-documented and differences in outcomes between Level-I and Level-II trauma centers are well-studied, data on the differences in outcomes between Level-II trauma centers (L2TCs) and Level-III trauma centers (L3TCs) are scarce.

OBJECTIVES: We sought to compare mortality risk between patients admitted to L2TCs and L3TCs, hypothesizing no difference in mortality risk for patients treated at L3TCs compared to L2TCs.

METHODS: A retrospective analysis of the 2016 Trauma Quality Improvement Program (TQIP) database was performed. Patients aged 18+ years were divided into 2 groups, those treated at American College of Surgeons (ACS) verified L2TCs and L3TCs.

RESULTS: From 74,486 patients included in this study, 74,187 (99.6%) were treated at L2TCs and 299 (.4%) at L3TCs. Both groups had similar median injury severity scores (ISSs) (10 vs 10, P <.001); however, L2TCs had a higher mean ISS (14.6 vs 11.9). There was a higher mortality rate for L2TC patients (6.0% vs 1.7%, P =.002) but no difference in associated risk of mortality between the 2 groups (OR.46, CI.14-1.50, P =.199) after adjusting predictors of mortality. L2TC patients had a longer median length of stay (5.0 vs 3.5 days, P <.001). There was no difference in other outcomes including myocardial infarction (MI) and cerebrovascular accident (CVA) (P >.05).

DISCUSSION: Patients treated at L2TCs had a longer LOS compared to L3TCs. However, after controlling for covariates, there was no difference in associated mortality risk between L2TC and L3TC patients.

Language: en

LA - en SN - 0003-1348 UR - http://dx.doi.org/10.1177/0003134820966290 ID - ref1 ER -