Trauma mortality in Orange County: the effect of implementation of a regional trauma system.
One hundred eighteen deaths from motor vehicle accidents were reviewed retrospectively to evaluate the effect of implementation of a regional trauma system. Fifty-eight deaths occurring prior to implementation and 60 occurring after were reviewed by teams of four physicians. Following implementation the proportion of potentially salvageable deaths dropped from 34% (20/58) to 15% (9/60) (P less than .02). Seven of the nine potentially salvageable deaths occurred in 13 patients treated in non-trauma facilities (54%), while only two potentially salvageable deaths occurred in 47 patients treated in trauma facilities (4%) (P less than .0002). The median age of patients dying of trauma rose from 22 to 27 years (P less than .04); the median Injury Severity Score rose from 42.5 to 52.0 (P less than .03). The 1981 death rate for vehicular trauma dropped to 13.93 per 100,000 population compared to a projected rate of 15.72 (P less than .03); the 1982 rate dropped to 12.37 compared to a projected rate of 15.80 (P less than .02). Implementation of a regional trauma system has resulted in significant improvements in trauma care and a reduction in the death rate from vehicular trauma.
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D000368:Aged; D002140:California; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D005392:First Aid; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D012040:Regional Health Planning; D012151:Resuscitation; D013997:Time Factors; D014187:Transportation of Patients; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000401:mortality* / Q000628:therapy