J Korean Soc Traumatol.  2017 Dec;30(4):131-139. 10.20408/jti.2017.30.4.131.

Mortality Reduction in Major Trauma Patients after Establishment of a Level I Trauma Center in Korea: A Single-Center Experience

• Roh YI
• Kim HI
• Cha YS
• Cha KC
• Kim H
• Lee KH
• Hwang SO
• Kim OH

• KMID: 2405276
• DOI: http://doi.org/10.20408/jti.2017.30.4.131

Abstract

PURPOSE
Trauma systems have been shown to decrease injury-related mortality. The present study aimed to compare the mortality rates of patients with major trauma (injury severity score >15) treated before and after the establishment of a level I trauma center.
METHODS
During this 20-month study, participants were divided into pre-trauma center and trauma center groups, and trauma and injury severity score (TRISS) method was used to compare mortality rates during 10-month periods before and after the establishment of the trauma center (October 2013 to July 2014 vs. October 2014 to July 2015).
RESULTS
Of the 541 total participants, 278 (51.5%) visited after the establishment of the trauma center. The Z and W statistics indicated better outcomes in the trauma center group than in the pre-trauma center group (Z statistic, 2.635 vs. −0.700; W statistic, 4.640). The trauma center group also exhibited meaningful reductions in the time interval from the emergency department (ED) visit to emergency surgery (118.0 minutes vs. 142.5 minutes, p=0.020) and the interval from the ED visit to intensive care unit admission (202.0 minutes vs. 259.0 minutes, p=0.035) relative to the pre-trauma center group.
CONCLUSIONS
The TRISS and multivariate analysis revealed significant improvements in survival rates in the trauma center group, compared to the pre-trauma center group.

Keyword

Trauma centers; Mortality; Wounds and injuries; Injury severity score; Survival rate

MeSH Terms

Emergencies
Emergency Service, Hospital
Humans
Injury Severity Score
Intensive Care Units
Korea*
Methods
Mortality*
Multivariate Analysis
Survival Rate
Trauma Centers*
Wounds and Injuries