In-house trauma attendings: is there a difference?
BACKGROUND
Outcomes of patients who met trauma activation criteria were examined before and after implementation of in-house attending call.


METHODS
Outcomes for the out-of-house period (OH) (February 1, 2001 to October 31, 2002) were compared with the in-house period (IH) (November 1, 2002 to June 30, 2004). Measures included overall mortality, length of stay (LOS) in the hospital, intensive care unit (ICU) and emergency department, and preventable deaths.


RESULTS
A total of 2,019 trauma activations were studied (1,036 OH, 983 IH). The groups were equivalent on admission. There was no difference in hospital LOS, ICU LOS, ventilator days, or overall mortality. Preventable deaths occurred in 8.1% of the OH group and in 1.0% of the IH group (P < .02).


CONCLUSIONS
Aggregate statistics and the use of surrogate markers to determine outcomes may not accurately portray the impact of attending surgeons on the quality of care. Implementation of in-house call resulted in a decreased incidence of preventable deaths.
Durham
Rodney
R
Department of Surgery, University of South Florida, Tampa General Hospital, 2 Columbia Drive, Suite G417, Tampa, FL 33606, USA. rdurham@hsc.usf.edu
Shapiro
David
D
Flint
Lewis
L
D000328:Adult; D005431:Florida / Q000453:epidemiology; D017052:Hospital Mortality; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies; D015996:Survival Rate; D014193:Trauma Centers / Q000706:statistics & numerical data*; D014505:Urban Population; D014947:Wounds and Injuries / Q000401:mortality* / Q000601:surgery