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Invited Commentary

Christopher C. Baker, MD
Arch Surg. 1995;130(2):220. doi:10.1001/archsurg.1995.01430020110021.
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The article by Demetriades and colleagues from the Department of Surgery at USC describes the impact of implementing a dedicated trauma program at LAC-USC Medical Center.The authors analyze outcome in patients with an ISS higher than 15 before and after implementation of the trauma program in 1991. The authors were able to identify reductions in mortality rates from 30% to 24% in 1993. It would be interesting to know how this breaks down between patients who were admitted to the intensive care unit (ICU) vs overall patients. We have previously studied this at Yale New Haven (Conn) Hospital,1 where we saw a drop in the overall mortality rate from 7.5% before to 5.8% 2 years after the trauma service implementation. More importantly in our study, the ICU mortality rate went from 17% to 11% to 4%, with the latter two numbers representing the first 2 years after implementation of the


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