EBQ:A national evaluation of the effect of trauma-center care on mortality

incomplete Journal Club Article

MacKenzie E. et el.. "A national evaluation of the effect of trauma-center care on mortality". NEJM. 2006. 354(4):366-78.
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Clinical Question

Is there a difference in mortality between trauma patients treated at level 1 trauma centers vs non-trauma centers?

Conclusion

The risk of death is significantly lower for patients treated at a trauma center than at non-trauma center.

Study Design

Prospective cohort study.

Population

Inclusion Criteria

• Age 18-84
• Arrived alive at the hospital
• At least one injury with a score ≥3 on the Abbreviated Injury Scale

Exclusion Criteria

• Arrived at hospital without vital signs and pronounced dead within 30 min of arrival
• Sought treatment >24 hr after injury
• Age ≥65 years with first listed diagnosis as hip fracture
• Neither English- nor Spanish-speaking
• Non-US residents
• Incarcerated or homeless at the time of injury

Outcomes

Primary Outcome

Mortality

Secondary Outcomes

None

Subgroup analysis

None