J Korean Soc Traumatol.  2015 Dec;28(4):241-247. 10.0000/jti.2015.28.4.241.

The Influence of How the Trauma Care System Is Applied at the Trauma Center: The Initial Experience at Single Trauma Center

• Kim HW
• Hong TH
• Lee SH
• Jung MJ
• Lee JG

• KMID: 2224034
• DOI: http://doi.org/10.0000/jti.2015.28.4.241

Abstract

PURPOSE
To evaluate the influence of how the trauma care system is applied on the management of trauma patients.
METHODS
We divided the patients into a pre-trauma system group and a post-trauma system group according to the time when we began to apply the trauma care system in our institution. We compared the general characteristics, injury severity score, initial response time to the trauma patients, number of preventable deaths, and clinical outcomes between the two groups.
RESULTS
The numbers of patients in the pre-trauma system group and the post-trauma system group were 188 and 257, respectively. No differences in the patient's median ages, trauma scores (ISS, RTS, TRISS) and proportions of severe trauma patients (ISS>15) were observed between the two groups. The number and the proportion of patients who were admitted to our hospital were increased in the post-trauma system group. The time interval from trauma CP activation to emergency surgery or angio-embolization, and the patient's time spent in emergency room were shortened in the posttrauma system group. However, the lengths of the ICU stay and the hospital stay, and the number of in-hospital mortalities were not improved in the post-trauma system group. In severe trauma patients (ISS>15), there were no differences between the two groups in the number and the proportion of admitted patients, and the time interval from trauma CP activation to performing a diagnostic and therapeutic procedure was not shortened in the post-trauma system group.
CONCLUSION
Application of the trauma care system has shortened the time between the initial response and patient management. However, this improvement was not enough to result in better clinical outcomes. More trauma physicians, multidisciplinary cooperation, and a well-organized trauma management process will be needed if the maximum efficacy of the trauma system is to be achieved.

Keyword

Trauma system; Trauma; Preventable death rates

MeSH Terms

Emergencies
Emergency Service, Hospital
Hospital Mortality
Humans
Injury Severity Score
Length of Stay
Reaction Time
Trauma Centers*