Impact of a Trauma System on Outcome of Severely Injured Patients

Authors:
  • SSSteven R. Shackford
    Steven R. Shackford
  • RMRobert C. Mackersie
    Robert C. Mackersie
  • DHDavid B. Hoyt
    David B. Hoyt
  • WBWilliam G. Baxt
    William G. Baxt
  • AEA. Brent Eastman
    A. Brent Eastman
  • FHFred N. Hammill
    Fred N. Hammill
  • FKF. Barry Knotts
    F. Barry Knotts
  • RVRichard W. Virgilio
    Richard W. Virgilio
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Abstract
• We examined the impact of a trauma system on the survival of patients with a Trauma Score of 8 or less. We compared the observed survival with that predicted using a method that calculates the probability of survival (Ps) based on age, physiologic score, and anatomic severity of injury. Of 3394 patients triaged to trauma centers in a 12-month period, 283 (8.3%) had a Trauma Score of 8 or less. Sufficient data were available in 189 patients with blunt trauma to make the survival comparison. The Pswas 18%; the observed survival was 29%. Of 60 patients with penetrating trauma and complete data, the Pswas 8%; the observed survival was 20%. We attribute the improved survival to the integration of prehospital and hospital care and expeditious surgery. (Arch Surg1987;122:523-527)