A statewide analysis of level I and II trauma centers for patients with major injuries.
BACKGROUND
This study examines statewide outcomes and resource use in Level I and II trauma centers for patients with major injuries.


METHODS
This study analyzed trauma registry data on patients admitted to North Carolina Level I and II trauma centers from January 1995 to December 1996 with one of four major injuries: thoracic aortic disruption, liver injury, pelvic fracture, or pulmonary contusion.


RESULTS
There were 59 thoracic aortic disruptions, 109 liver injuries, 153 pelvic fractures, and 962 pulmonary contusions identified among 26,030 admissions. Case fatality was not significantly different (Level I, 16.8%; Level II, 14.9%). Hospital charges were significantly higher in Level I centers (Level I, $47,366; Level II, $35,490), but this difference was confined to transferred patients. Controlling for Revised Trauma Score, Injury Severity Score, age, gender, and race, multivariable regression confirmed findings regarding hospital charges, and multiple logistic regression confirmed findings regarding case fatality.


CONCLUSIONS
Case fatality was similar in Level I and Level II trauma centers in North Carolina, and hospital charges were comparable in patients with comparable injuries not requiring transfer. This suggests that patients with major injuries may be optimally cared for in both Level I and Level II trauma centers.
Clancy
T V
TV
Department of Surgery, The University of North Carolina at Chapel Hill, USA. tclancy@med.unc.edu
Gary Maxwell
J
J
Covington
D L
DL
Brinker
C C
CC
Blackman
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D006295:Health Resources / Q000191:economics; D017722:Hospital Charges / Q000706:statistics & numerical data*; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D010360:Patient Transfer / Q000191:economics / Q000706:statistics & numerical data; D014193:Trauma Centers / Q000191:economics / Q000706:statistics & numerical data*; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000191:economics / Q000401:mortality*