The volume-outcomes relationship for United States Level I trauma centers.

Published

Journal Article

BACKGROUND: Previous studies of the center volume-outcomes relationship for severe trauma care have yielded conflicting findings regarding the presence or nature of such a relationship. Few studies have confined their analysis to Level I centers. METHODS: We performed a retrospective analysis of severely injured adults treated from 2001 through 2006 in United States Level I trauma centers using data from the National Trauma Data Bank version 7.1. The post-injury in-hospital mortality rates for patients treated at high- or medium-volume Level I trauma centers were compared with the rates for patients treated at low-volume Level I centers before and after adjustment for patient demographic and injury characteristics. Subgroup comparisons were performed for those Level I centers with and without American College of Surgeons (ACS) verification of Level I designation. RESULTS: Overall, medium-volume Level I trauma centers had significantly lower mortality than low-volume centers (14.3% versus 15.6%), both before and after adjustment for patient demographic and injury characteristics. Of those trauma centers without ACS verification of Level I designation, high-volume centers had significantly greater mortality than low-volume centers. CONCLUSIONS: Our findings support the current utilization by the American College of Surgeons of minimum annual volume requirements for the verification of Level I trauma center designation, and suggest that the presence of such verification may enable Level I centers to effectively manage high volume of severely injured adult patients.

Full Text

Duke Authors

Cited Authors

  • Bennett, KM; Vaslef, S; Pappas, TN; Scarborough, JE

Published Date

  • May 1, 2011

Published In

Volume / Issue

  • 167 / 1

Start / End Page

  • 19 - 23

PubMed ID

  • 20701925

Pubmed Central ID

  • 20701925

Electronic International Standard Serial Number (EISSN)

  • 1095-8673

Digital Object Identifier (DOI)

  • 10.1016/j.jss.2010.05.020

Language

  • eng

Conference Location

  • United States