Improved trauma care in a rural hospital after establishing a level II trauma center.
A study of motor vehicle accident deaths occurring in Napa County, California, from 1979 through 1983 showed that there was a preventable death rate of 42% for deaths that were not related to central nervous system injuries. After developing a Level II trauma center at our hospital, the preventable death rate decreased to 14%. This was statistically significant (total chi-square, 0.01 less than p less than 0.025). There was a significant increase in the average Injury Severity Score (34 versus 45, p less than 0.005) as well as significant improvements in the surgeon's response time (32 minutes versus 11 minutes, p less than 0.005) and in the time from hospital arrival to the start of surgery (3.6 hours versus 1.9 hours, 0.01 less than p less than 0.025). We conclude that these changes are indicative of improved trauma care and reflect favorably upon the effectiveness of a rural trauma center that meets Level II trauma center guidelines established by the American College of Surgeons Committee on Trauma.
Wenneker
W W
WW
Department of Surgery, Queen of the Valley Hospital, Napa, CA.
Murray
D H
DH
Ledwich
T
T
D000063:Accidents, Traffic / Q000401:mortality*; D000328:Adult; D002140:California / Q000453:epidemiology; D005260:Female; D006287:Health Planning Guidelines; D006780:Hospitals, Rural / Q000592:standards*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D012424:Rural Population; D014193:Trauma Centers / Q000592:standards*; D014947:Wounds and Injuries / Q000401:mortality* / Q000628:therapy