Impact of the in-house trauma surgeon on initial patient care, outcome, and cost. Commentary.
The purpose of this study is to evaluate the effect of having attending trauma surgeons with added qualifications in surgical critical care present for the initial resuscitation at a regional trauma center.
This study is a retrospective review of patients admitted between August of 1994 and December of 1995 from our trauma registry.
The patients were categorized by the call preference of the admitting physician as in-house (IH) or call-back from home (CB), day of admission (weekend vs. weekday), time of admission (AM vs.
PM), and a value of the injury severity scale ¾15 or>15.
Demographics, admission vital signs, Injury Severity Scale, Glasgow Coma Score, and elapsed time to diagnostic, therapeutic, and/or operative interventions were studied.
The effect on intensive care unit length of stay, mortality, and hospital cost for resuscitation were also studied.
The study population consisted of 1,043 patients.
The IH and CB groups each included two attending surgeons.
IH significantly reduced the average time to completion of diagnostic peritoneal lavage (22 vs. 34 minutes ; p<0.05), therapeutic intervention (21 vs 38 minutes ; p<0.05), and transport to the operating room (206 vs. 312 minutes ; p<0.05) during the AM compared with CB.
There was no difference in these times for the PM admissions.
There was no significant difference in intensive care unit length of stay. (...)
Mots-clés Pascal : Traumatologie, Chirurgie, Réanimation, Etude comparative, Disponibilité, Chirurgien, Diagnostic, Traitement, Pronostic, Epidémiologie, Analyse coût efficacité
Mots-clés Pascal anglais : Traumatology, Surgery, Resuscitation, Comparative study, Availability, Surgeon, Diagnosis, Treatment, Prognosis, Epidemiology, Cost efficiency analysis
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0251603
Code Inist : 002B30A05. Création : 11/06/1997.