Influence of a statewide trauma system on location of hospitalization and outcome of injured patients. Discussion.
Annual Meeting of the American Association for the Surgery of Trauma. Halifax, Nova Scotia CAN, 1995/09/27.
Evaluate the influence of implementing the Oregon statewide trauma system on admission distribution and risk of death.
Retrospective pre-and posttrauma system analyses of hospital discharge data regarding injured patients with one or more of the following injuries : head, chest, spleen/liver, pelvic fracture, and femur/tibia fracture.
Materials and Methods
Risk-adjusted odds ratio of admission to Level I or II (tertiary care) trauma centers, and odds ratio of death were determined using hospital discharge abstract data on 27,633 patients.
Patients treated in 1985-1987, before trauma system establishment, were compared to patients treated in 1991-1993 after the trauma system was functioning.
Measurements and Main Results
After trauma system implementation, the odds ratio of admission to Level I or II trauma centers increased (odds ratio 2.36,95% confidence interval 2.24-2.49).
In addition, the odds ratio of death for injured patients declined after trauma system establishment (odds ratio 0.82, confidence interval 0.73-0.92).
The Oregon trauma system was successfully implemented with more patients with index injuries admitted to hospitals judged most capable of managing trauma patients.
The Oregon trauma system also appears beneficial since trauma system establishment is associated with a statewide reduction in risk of death.
Mots-clés Pascal : Traumatisme, Evaluation, Catégorisation, Echelle évaluation, Relation, Hospitalisation, Efficacité, Evolution, Etude cas, Homme, Oregon, Etats Unis, Amérique du Nord, Amérique, Réanimation
Mots-clés Pascal anglais : Trauma, Evaluation, Categorization, Evaluation scale, Relation, Hospitalization, Efficiency, Evolution, Case study, Human, Oregon, United States, North America, America, Resuscitation
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0230667
Code Inist : 002B16N. Création : 199608.