This cohort study evaluates the differences in access to and outcomes of 9-1-1 emergency medical services’ response to injuries in rural and urban populations.
This nationwide survey study identifies the number of trauma hospitals operating in Syria and delineates their capacities.
This multicenter cohort study of a trauma system in Canada reports the development of a quality indicator for in-hospital complications that can be used to evaluate the quality of acute injury care.
This case series discusses the inpatient resources, including imaging, nursing overtime, and blood bank needs, that were used to treat 63 individuals injured in the Asiana Airlines flight 214 crash.
This analysis assesses the reported prevalence of domestic violence among trauma patients.
This cohort study reports increased mortality rates among injured children aged 18 years or younger who were treated at adult trauma centers and mixed trauma centers compared with those treated at pediatric trauma centers.
Nicol et al formalize injury data collection at Groote Schuur Hospital, the chief academic hospital of the University of Cape Town, a level I trauma center, and one of the largest trauma referral hospitals in the world.
Using the 2009 Nationwide Emergency Department Sample, Delgado et al determine factors associated with the decision to admit rather than transfer severely injured patients who are initially seen at non–trauma center EDs and ascertain whether insured patients are more likely to be admitted than transferred. See the Invited Commentary by Mabry.
Sorensen et al describe the burden of secondary overtriage in a rural trauma system with a single level I trauma center.
To estimate the likelihood of trauma center admission for injured elderly patients with trauma, determine trends in trauma center admissions, and identify factors associated with trauma center use for elderly patients with trauma.
Acute care hospitals in California.
All patients hospitalized for acute traumatic injuries during the period from January 1, 1999, to December 31, 2008 (n = 430 081). Patients who had scheduled admissions for nonacute or minor trauma were excluded.
Likelihood of admission to level I or II trauma center was calculated according to age categories after adjusting for patient and system factors.
Of 430 081 patients admitted to California acute care hospitals for trauma-related diagnoses, 27% were older than 65 years. After adjusting for demographic, clinical, and system factors, compared with trauma patients aged 18-25 years, the odds of admission to a trauma center decreased with increasing age; patients aged 26-45 years had lower odds (odds ratio [OR], 0.75; 95% confidence interval [CI], 0.71-0.80) of being admitted to a trauma center for their injuries than did patients 46-65 years of age (OR, 0.57; 95% CI, 0.54-0.60), patients 66-85 years of age (OR, 0.35; 95% CI, 0.30-0.41), and patients older than 85 years (OR, 0.30; 95% CI, 0.25-0.36). Similar patterns were found when stratifying the analysis by trauma type and severity. Living more than 50 miles away from a trauma center (OR, 0.03; 95% CI, 0.01-0.06) and lack of county trauma center (OR, 0.17; 95% CI, 0.09-0.35) were also predictors of not receiving trauma care.
Age and likelihood of admission to a trauma center for injured patients were observed to be inversely proportional after controlling for other factors. System-level factors play a major role in determining which injured patients receive trauma care.