Do designated trauma systems improve outcome?
OBJECTIVE
Trauma systems are introduced world wide with the goal to improve survival and outcome of the injured patient. This review is focused on the influence of trauma systems on the survival and outcome of injured patients.


RESULTS
Large population-based studies have been published over the last 2 years strengthening the hypothesis that trauma systems indeed improve survival rates in injured patients. Mortality was reduced by 15-25% when severely injured patients were treated at a trauma center. Although 'inclusive' trauma systems have been advocated since 1991 only recently did the first population-based study prove that 'inclusive' trauma systems do better than 'exclusive' trauma systems. Because further improvements in survival in mature trauma systems are likely to be small, more focus should be given to quality of life studies, rather than to survival in trauma system evaluation.


CONCLUSIONS
Trauma systems indeed improve survival rates in injured patients. Inclusive trauma systems do better than exclusive trauma systems. More attention should be given to quality of outcome.
Lansink
Koen W W
KW
Department of Surgery, UMC Utrecht, Utrecht, The Netherlands.
Leenen
Luke P H
LP
D006801:Humans; D009426:Netherlands; D014193:Trauma Centers / Q000458:organization & administration*; D015599:Trauma Severity Indices; D014194:Traumatology; D016896:Treatment Outcome; D014218:Triage; D014947:Wounds and Injuries / Q000401:mortality / Q000628:therapy*