title: [The model of the Niguarda Hospital Trauma Team in Milan].
abstract: The aim of this work was to describe the model and clinical results obtained by the Niguarda Trauma Team referral center for major trauma, in Milan. The Trauma Team is organized as a trauma service, where general surgeons, anesthesiologists, orthopedic surgeons and neurosurgeons work on a 24 hour rotation. When not in duty in the rotations, specialists work in their specific elective activities. The director of the Trauma Team has the responsibility for discussion and application of protocols, clinical assistance, quality assessment and training. The results of 1334 consecutive cases of major trauma during a 51 month period were reviewed using the trauma registry. 39% overtriage, which increased over the years, and 1.12% undertriage were recorded. Mortality of patients with injury severity scores > 15 was 21%, with a progressive decrease over the years. Blunt trauma accounted for 91.75% and were road-related in most cases. Skeletal injuries were the most frequent findings, but brain and thoraco-abdominal injuries were associated with a higher risk of death. 1476 surgical procedures (16.93% general surgery and 111 interventional angiographic studies) were performed. Quality assessment revealed a significant decrease in preventable deaths within the first 72 hours, after excluding patients admitted in extremis. The results presented in this study demonstrate the possibility of realising a model of organized trauma care in an emergency department in Italy, with patient outcomes comparable to those obtained in Trauma Center in other countries.
authors.affiliation: Dipartimento DEA-EAS, Ospedale Niguarda Ca' Granda, Milano.
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Chiara
authors.forename: Stefania
authors.initials: S
authors.lastname: Cimbanassi
authors.forename: Sara
authors.initials: S
authors.lastname: Andreani
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Sammartano
authors.forename: Giacinto
authors.initials: G
authors.lastname: Pizzilli
authors.forename: Paolo
authors.initials: P
authors.lastname: Girotti
authors.forename: Anna
authors.initials: A
authors.lastname: Mariani
authors.forename: Gabriele
authors.initials: G
authors.lastname: Bassi
authors.forename: Fabio
authors.initials: F
authors.lastname: Baticci
authors.forename: Alfredo
authors.initials: A
authors.lastname: Fontana
authors.forename: Massimo
authors.initials: M
authors.lastname: Mariani
authors.forename: Massimo
authors.initials: M
authors.lastname: Massi
authors.forename: Carlo
authors.initials: C
authors.lastname: Pozzi
authors.forename: Marco Vittorio Rossi
authors.initials: MV
authors.lastname: Ardizzone
authors.forename: Fabio
authors.initials: F
authors.lastname: Sansonna
authors.forename: Sergio
authors.initials: S
authors.lastname: Vesconi
authors.forename: Raffaele
authors.initials: R
authors.lastname: Pugliese
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D017146:Models, Organizational; D010348:Patient Care Team / Q000458:organization & administration*; D014193:Trauma Centers / Q000458:organization & administration*; D014947:Wounds and Injuries / Q000453:epidemiology / Q000628:therapy*