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The rapid impact on mortality rates of a dedicated care team including trauma and emergency physicians at an academic medical center.

Publication ,  Journal Article
Gerardo, CJ; Glickman, SW; Vaslef, SN; Chandra, A; Pietrobon, R; Cairns, CB
Published in: J Emerg Med
May 2011

BACKGROUND: Trauma center designation can result in improved patient outcomes after injuries. Whereas the presence of trauma teams has been associated with improved trauma patient outcomes, the specific components, including the role of emergency medicine (EM)-trained, board-certified emergency physicians, have not been defined. OBJECTIVE: To assess the outcomes of patients before and after the establishment of a dedicated trauma team that incorporated full-time EM-trained physicians with trauma specialists at a Level I trauma center at an academic institution. METHODS: Secondary analysis of prospectively collected trauma registry data was performed to compare mortality rates of all treated trauma patients before and after this intervention. RESULTS: The establishment of a dedicated specialty trauma team incorporating full-time EM presence including EM-trained, board-certified emergency physicians was associated with a reduction in overall non-DOA (dead on arrival) mortality rate from 6.0% to 4.1% from the time period preceding (1999-2000) to the time period after (2002-2003) this intervention (1.9% absolute reduction in mortality, 95% confidence interval [CI] 0.7%-3.0%). Among patients who were most severely injured (Injury Severity Score [ISS] ≥ 25), mortality rates decreased from 30.2% to 22.0% (8.3% absolute reduction in mortality, 95% CI 2.1%-14.4%). In comparison, there was minimal change in national mortality rates for patients with ISS ≥ 25 during the same time period (33% to 34%). CONCLUSIONS: The implementation of a dedicated full-time trauma team incorporating both trauma surgeons and EM-trained, board-certified or -eligible emergency physicians was associated with improved mortality rates in trauma patients treated at a Level I academic medical center, including those patients presenting with the most severe injuries.

Duke Scholars

Published In

J Emerg Med

DOI

ISSN

0736-4679

Publication Date

May 2011

Volume

40

Issue

5

Start / End Page

586 / 591

Location

United States

Related Subject Headings

  • Wounds and Injuries
  • Trauma Centers
  • Registries
  • Prospective Studies
  • Patient Care Team
  • Outcome and Process Assessment, Health Care
  • Male
  • Injury Severity Score
  • Humans
  • Hospital Mortality
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Gerardo, C. J., Glickman, S. W., Vaslef, S. N., Chandra, A., Pietrobon, R., & Cairns, C. B. (2011). The rapid impact on mortality rates of a dedicated care team including trauma and emergency physicians at an academic medical center. J Emerg Med, 40(5), 586–591. https://doi.org/10.1016/j.jemermed.2009.08.056
Gerardo, Charles J., Seth W. Glickman, Steven N. Vaslef, Abhinav Chandra, Ricardo Pietrobon, and Charles B. Cairns. “The rapid impact on mortality rates of a dedicated care team including trauma and emergency physicians at an academic medical center.J Emerg Med 40, no. 5 (May 2011): 586–91. https://doi.org/10.1016/j.jemermed.2009.08.056.
Gerardo CJ, Glickman SW, Vaslef SN, Chandra A, Pietrobon R, Cairns CB. The rapid impact on mortality rates of a dedicated care team including trauma and emergency physicians at an academic medical center. J Emerg Med. 2011 May;40(5):586–91.
Gerardo, Charles J., et al. “The rapid impact on mortality rates of a dedicated care team including trauma and emergency physicians at an academic medical center.J Emerg Med, vol. 40, no. 5, May 2011, pp. 586–91. Pubmed, doi:10.1016/j.jemermed.2009.08.056.
Gerardo CJ, Glickman SW, Vaslef SN, Chandra A, Pietrobon R, Cairns CB. The rapid impact on mortality rates of a dedicated care team including trauma and emergency physicians at an academic medical center. J Emerg Med. 2011 May;40(5):586–591.
Journal cover image

Published In

J Emerg Med

DOI

ISSN

0736-4679

Publication Date

May 2011

Volume

40

Issue

5

Start / End Page

586 / 591

Location

United States

Related Subject Headings

  • Wounds and Injuries
  • Trauma Centers
  • Registries
  • Prospective Studies
  • Patient Care Team
  • Outcome and Process Assessment, Health Care
  • Male
  • Injury Severity Score
  • Humans
  • Hospital Mortality