TY - JOUR PY - 2024// TI - Effects of trauma center consolidation on adult trauma at a rural Level 1 trauma center JO - American surgeon A1 - Heard, Matthew A. A1 - Bray, Sheree A1 - Archer, Allen A1 - O'Quinn, Payton C. A1 - Wheeler, Hannah A1 - Leonard, Matthew A1 - Burns, J. Bracken SP - ePub EP - ePub VL - ePub IS - ePub N2 - OBJECTIVE: The aim was to determine the impact of consolidation of two rural level 1 trauma centers on adult trauma patients presenting to the remaining level 1 trauma center. To our knowledge, a study assessing the impact of trauma center consolidation on adult trauma patients had yet to be performed.

METHODS: A single institution, retrospective study was conducted at a rural level 1 trauma center. Adult trauma patients who presented to our center from January 2017 to January 2022 were included. The cohorts spanned 33 months pre- and post-consolidation. Multiple demographic and outcome measures were gathered. Data were analyzed using the student's t-test and Chi-squared testing.

RESULTS: There was a 33% increase in overall trauma activations and 9% increase in transfers from outside facilities post-consolidation. The post-consolidation group was significantly older, had higher mean injury severity score, and decreased hospital-free days. The post-consolidation group also saw an increase in ICU admission and surgical intervention. While there were no significant differences in ICU-free days or ventilator days, patients in the post-consolidation group with the highest level of activation who required both surgical intervention and ICU admission experienced decreased mortality.

CONCLUSION: The consolidation of trauma services to a single level 1 trauma center in a rural Appalachian health system led to higher trauma volume and acuity, but most importantly decreased mortality for the most severely injured trauma patients.

Language: en

LA - en SN - 0003-1348 UR - http://dx.doi.org/10.1177/00031348241241703 ID - ref1 ER -