alexa Impact of trauma center designation on outcomes: is there a difference between Level I and Level II trauma centers?
Pediatrics

Pediatrics

Clinical Pediatrics: Open Access

Author(s): Glance LG, Osler TM, Mukamel DB, Dick AW

Abstract Share this page

Abstract BACKGROUND: Within organized trauma systems, both Level I and Level II trauma centers are expected to have the resources to treat patients with major multisystem trauma. The evidence supporting separate designations for Level I and Level II trauma centers is inconclusive. The objective of this study was to compare mortality and complications for injured patients admitted to Level I and Level II trauma centers. STUDY DESIGN: Using data from the Pennsylvania Trauma Outcomes Study registry, we performed a retrospective observational study of 208,866 patients admitted to 28 Level I and Level II trauma centers between 2000 and 2009. Regression modeling was used to estimate the association between patient outcomes and trauma center designation, after controlling for injury severity, mechanism of injury, transfer status, and physiology. RESULTS: Patients admitted to Level I trauma centers had a 15\% lower odds of mortality (adjusted odds ratio [adj OR] 0.85; 95\% CI 0.72 to 0.99) and a 35\% increased odds of complications (adj OR 1.37; 95\% CI 1.04 to 1.79). The survival benefit associated with admission to Level I centers was strongest in patients with very severe injuries (Injury Severity Score [ISS] ≥ 25; adj OR 0.78; 95\% CI 0.64 to 0.95). Less severely injured patients with an ISS < 9 (adj OR 0.91; 95\% CI 0.64 to 1.30) and with an ISS between 9 and 15 (adj OR 0.98; 95\% CI 0.81 to 1.18) had similar risks of mortality in Level I and Level II trauma centers. CONCLUSIONS: Severely injured patients admitted to Level I trauma centers have a lower risk of mortality compared with patients admitted to Level II centers. These findings support the continuation of a 2-tiered designation system for trauma. Copyright © 2012 American College of Surgeons. Published by Elsevier Inc. All rights reserved. This article was published in J Am Coll Surg and referenced in Clinical Pediatrics: Open Access

Relevant Expert PPTs

Relevant Speaker PPTs

Recommended Conferences

Relevant Topics

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

[email protected]

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

[email protected].com

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

[email protected]

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords