Journal of Emergencies, Trauma, and Shock
Home About us Editors Ahead of Print Current Issue Archives Search Instructions Subscribe Advertise Login 
Users online:572   Print this pageEmail this pageSmall font sizeDefault font sizeIncrease font size   
Year : 2020  |  Volume : 13  |  Issue : 3  |  Page : 201-207

Variability in current trauma systems and outcomes

1 Department of Surgery, Kendall Regional Medical Center, Miami, FL, USA
2 Department of Trauma, HCA-South Atlantic Division, Charleston, SC, USA
3 Department of Surgery, Kendall Regional Medical Center, Miami; Department of Surgery, University of South Florida, Tampa, FL, USA

Correspondence Address:
Dr. Adel Elkbuli
Kendall Regional Medical Center, 11750 Bird Road, Miami, FL 33175
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JETS.JETS_49_19

Rights and Permissions

Background: Complication rates may be indicative of trauma center (TC) performance. The complication rates between Level 1 and 2 TCs at the national level are unknown. Our study aimed to determine the relationship between American College of Surgeons (ACS)-verified and state-designated TCs and complications. Study Design and Methods: This was a cohort review of the National Sample Program (NSP) from the National Trauma Data Bank, the world's largest validated trauma database. TCs were categorized by ACS or state Level 1 or 2. TCs not categorized as Level 1 or 2 were excluded. All 22 complications provided by the NSP were analyzed. Chi-squared analysis was used with statistical significance defined asP < 0.05.Results: Of the 94 TCs in the NSP, 67 had ACS and 80 had state designations of Level 1 or 2. There were 38 ACS Level 1 TCs treating 87,340 patients and 29 ACS Level 2 TCs treating 35,763. There were 45 state Level 1 TCs treating 106,640 and 35 state Level 2 TCs treating 43,290. ACS Level 1 TCs had significantly higher complications compared to ACS Level 2 TCs (13.5% [11,776/87,340] vs. 10.1% [3,606/35,763],P < 0.0001). In addition, state Level 1 TCs had significantly more complications compared to state Level 2 TCs (4.4% [4,681/106,640] vs. 1.6% [673/43,290],P < 0.0001). Conclusion: Both ACS and state Level 2 TCs had significantly lower complication rates than ACS and state Level 1 TCs. Further investigations should look for the source and impact of this difference.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded46    
    Comments [Add]    

Recommend this journal