TY  - JOUR
PY  - 2024//
TI  - Does the implementation of a trauma system affect injury-related morbidity and economic outcomes? A systematic review
JO  - Emergency medicine journal
A1  - Bath, Michael F.
A1  - Hobbs, Laura
A1  - Kohler, Katharina
A1  - Kuhn, Isla
A1  - Nabulyato, William
A1  - Kwizera, Arthur
A1  - Walker, Laura E.
A1  - Wilkins, Tom
A1  - Stubbs, Daniel
A1  - Burnstein, R. M.
A1  - Kolias, Angelos
A1  - Hutchinson, Peter John
A1  - Clarkson, P. John
A1  - Halimah, Sara
A1  - Bashford, Tom
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Trauma accounts for a huge burden of disease worldwide. Trauma systems have been implemented in multiple countries across the globe, aiming to link and optimise multiple aspects of the trauma care pathway, and while they have been shown to reduce overall mortality, much less is known about their cost-effectiveness and impact on morbidity. <br><br>METHODS: We performed a systematic review to explore the impact the implementation of a trauma system has on morbidity, quality of life and economic outcomes, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. All comparator study types published since 2000 were included, both retrospective and prospective in nature, and no limits were placed on language. Data were reported as a narrative review. <br><br>RESULTS: Seven articles were identified that met the inclusion criteria, all of which reported a pre-trauma and post-trauma system implementation comparison in high-income settings. The overall study quality was poor, with all studies demonstrating a severe risk of bias. Five studies reported across multiple types of trauma patients, the majority describing a positive impact across a variety of morbidity and health economic outcomes following trauma system implementation. Two studies focused specifically on traumatic brain injury and did not demonstrate any impact on morbidity outcomes. <br><br>DISCUSSION: There is currently limited and poor quality evidence that assesses the impact that trauma systems have on morbidity, quality of life and economic outcomes. While trauma systems have a fundamental role to play in high-quality trauma care, morbidity and disability data can have large economic and cultural consequences, even if mortality rates have improved. The sociocultural and political context of the surrounding healthcare infrastructure must be better understood before implementing any trauma system, particularly in resource-poor and fragile settings. PROSPERO REGISTRATION NUMBER: CRD42022348529 LEVEL OF EVIDENCE: Level III.<p />  <p>Language: en</p>
LA  - en
SN  - 1472-0205
UR  - http://dx.doi.org/10.1136/emermed-2023-213782
ID  - ref1
ER  -