Influence of In-House Attending Presence on Trauma Outcomes and Hospital Efficiency

Cox, Jessica; Bernard, Andrew C.; Bottiggi, Anthony J.; Chang, Pei Ching; Talley, Cynthia L.; Tucker, Brian; Davenport, Daniel L.; Kearney, Paul A.

doi:10.1016/j.jamcollsurg.2013.12.027

Cited by 21 publications

(37 citation statements)

References 4 publications

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“…The development of designated trauma services or trauma teams for the management of severely injured patients in high volume centers decreases mortality (37,38). Also, the presence of inhouse coverage by trauma surgeons at high volume centers is believed to improve outcomes, although there is no empirical evidence showing an actual decrease in mortality (39,40).…”

Section: Discussionmentioning

confidence: 99%

The volume-outcome relationship in severely injured patients: A systematic review and meta-analysis

Sewalt

Wiegers

Venema

et al. 2018

J Trauma Acute Care Surg

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Section: Discussionmentioning

confidence: 99%

The volume-outcome relationship in severely injured patients: A systematic review and meta-analysis

Sewalt

Wiegers

Venema

et al. 2018

J Trauma Acute Care Surg

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“…[21] A previous study examining this criterion did not identify a difference in outcomes with out-hospital or in-hospital response of attending surgeon, provided that response is within a defined period of time. [22] Moreover, Level I centers require a minimum annual patient load of critically injured patients in addition to research aimed at improving trauma care. [21] No increase in survival was however reported with higher trauma center volumes both at state level (New York) [23] and nationwide using the NTDB.…”

Section: Discussionmentioning

confidence: 99%

Impact of trauma designation levels on survival of drowning victims

2019

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Drowning causes significant morbidity and mortality. Healthcare regionalization aims at improving patient outcomes. This study examines the impact of trauma center level designation on survival of drowning victims.Retrospective cohort study utilizing the National Trauma Data Bank (NTDB) 2015. Descriptive, bivariate and multivariate analyses were conducted.The 212 patients were included. Mean age was 33.58 (±20.02) years with 69.3% (n = 147) males. Patients were mostly taken to Level I (n = 107, 50.5%) and II (n = 81, 32.8%) centers, requiring admission (43.5% (n = 96), 23.1% (n = 49) and 8.5% (n = 18) to Intensive Care, floor, and Operating Room, respectively). Overall hospital discharge survival was 83.5% (n = 177). After adjusting for confounders, there was no significant difference in survival of patients taken to Level I compared to Level II and III centers.This study did not identify a survival benefit for patients with drowning related injuries when taken to Level I compared to Level II or III Trauma centers. Further outcome studies are needed in organized trauma systems to improve field triage criteria for specific injury mechanisms.

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“…The next reason might be that the development of designated trauma teams for the management of severely injured patients in high-volume centers decreased mortality [16,17]. Particularly, it has been suggested that a trauma team centered around in-house trauma surgeons with much experiences and skills has a positive impact on the trauma care and outcomes among severely injured patients, although there is no definitive evidence [2,18,19]. The final reason might be that the change in infrastructure including medical resources at a high-volume center, such as new technological improvements and the introduction of development products, could lead to a decrease in mortality [7].…”

Section: Discussionmentioning

confidence: 99%

Correlation between Hospital Volume of Severely Injured Patients and In-Hospital Mortality of Severely Injured Pediatric Patients in Japan: A Nationwide 5-Year Retrospective Study

Toida

Muguruma

Gakumazawa

et al. 2021

JCM

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Appropriate trauma care systems, suitable for children are needed; thus, this retrospective nationwide study evaluated the correlation between the annual total hospital volume of severely injured patients and in-hospital mortality of severely injured pediatric patients (SIPP) and compared clinical parameters and outcomes per hospital between low- and high-volume hospitals. During the five-year study period, we enrolled 53,088 severely injured patients (Injury Severity Score, ≥16); 2889 (5.4%) were pediatric patients aged <18 years. Significant Spearman correlation analysis was observed between numbers of total patients and SIPP per hospital (p < 0.001), and the number of SIPP per hospital who underwent interhospital transportation and/or urgent treatment was correlated with the total number of severely injured patients per hospital. Actual in-hospital mortality, per hospital, of SIPP patients was significantly correlated with the total number patients per hospital (p < 0.001,). The total number of SIPP, requiring urgent treatment, was higher in the high-volume than in the low-volume hospital group. No significant differences in actual in-hospital morality (p = 0.246, 2.13 (0–8.33) vs. 0 (0–100)) and standardized mortality ratio (SMR) values (p = 0.244, 0.31 (0–0.79) vs. 0 (0–4.87)) were observed between the two groups; however, the 13 high-volume hospitals had an SMR of <1.0. Centralizing severely injured patients, regardless of age, to a higher volume hospital might contribute to survival benefits of SIPP.

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Influence of In-House Attending Presence on Trauma Outcomes and Hospital Efficiency

Cited by 21 publications

References 4 publications

The volume-outcome relationship in severely injured patients: A systematic review and meta-analysis

The volume-outcome relationship in severely injured patients: A systematic review and meta-analysis

Impact of trauma designation levels on survival of drowning victims

Correlation between Hospital Volume of Severely Injured Patients and In-Hospital Mortality of Severely Injured Pediatric Patients in Japan: A Nationwide 5-Year Retrospective Study

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