Trauma Patient Volume and the Quality of Care: A Scoping Review

Abstract

Background: Healthcare stakeholders in the Netherlands came to an agreement in 2022 to deal with present and future challenges in healthcare. Among others, this agreement contains clear statements regarding the concentration of trauma patients, including the minimal required number of annual severe trauma patients for Major Trauma Centers. This review investigates the effects of trauma patient volumes on several domains of the quality of healthcare. Methods: PubMed was searched; studies published during the last 10 years reporting quantitative data on trauma patient volume and quality of healthcare were included. Results were summarized and categorized into the quality domains of healthcare. Results: Seventeen studies were included with a total of 1,517,848 patients. A positive association between trauma patient volume and survival was observed in 11/13 studies with adjusted analyses. Few studies addressed other quality domains: efficiency (n = 5), safety (n = 2), and time aspects of care (n = 4). None covered people-centeredness, equitability, or integrated care. Conclusions: Most studies showed a better survival of trauma patients when treated in high-volume hospitals compared to lower volume hospitals. However, the ideal threshold could not be determined. The association between trauma volume and other domains of the quality of healthcare remains unclear.

Systematic analysis of MASP-1 serves as a novel immune-related biomarker in sepsis and trauma followed by preliminary experimental validation

“…Traumatic sepsis patients were trauma patients who developed sepsis within a few days of the injury. The adult trauma patients with injury severity score (ISS) (based on site of trauma, types of trauma, circulation, consciousness, and breathing) higher than 9 were recruited in the study ( 2 ). Sepsis or septic shock was diagnosed according to the Third International Consensus Definitions for Sepsis and Septic Shock ( 15 ).…”

“…It is the leading cause of death among people aged <45 years. Moreover, it has the highest real economic and social cost of any disease ( 1 , 2 ). Trauma initiates a complex immune response in the minutes after the initial insult, and patients subjected to severe trauma are at risk of developing sepsis ( 3 ).…”