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J Trauma Inj. 2017 Dec;30(4):131-139. English. Original Article. https://doi.org/10.20408/jti.2017.30.4.131
Roh YI , Kim HI , Cha YS , Cha KC , Kim H , Lee KH , Hwang SO , Kim OH .
Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. ardentem@gmail.com
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.

Copyright © 2019. Korean Association of Medical Journal Editors.