Impact of a Trauma System on Outcome of Severely Injured Patients

Steven R. Shackford, MD; Robert C. Mackersie, MD; David B. Hoyt, MD; William G. Baxt, MD; A. Brent Eastman, MD; Fred N. Hammill, MD; F. Barry Knotts, MD; Richard W. Virgilio, MD
Arch Surg. 1987;122(5):523-527. doi:10.1001/archsurg.1987.01400170029003.
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• 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 Ps was 18%; the observed survival was 29%. Of 60 patients with penetrating trauma and complete data, the Ps was 8%; the observed survival was 20%. We attribute the improved survival to the integration of prehospital and hospital care and expeditious surgery.

(Arch Surg 1987;122:523-527)


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