title: Preventable morbidity at a mature trauma center.
abstract: OBJECTIVE
  To analyze the preventable and potentially preventable complications occurring at a mature level I trauma center.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Academic level I trauma center.
  
  
  METHODS
  The study included 35 311 trauma registry patients.
  
  
  METHODS
  The cause, effect on outcome, preventability (preventable, potentially preventable, or nonpreventable), and loop closure recommendations for all preventable and potentially preventable complications, and clinical data related to each complication retrieved from the trauma registry and individual medical records.
  
  
  RESULTS
  Over the 8-year study, 35 311 trauma registry patients experienced 2560 complications. Three hundred fifty-one patients (0.99% of all patients) had 403 preventable or potentially preventable complications. The most common preventable or potentially preventable complications were unintended extubation (63 patients [17% of complications]), surgical technical failures (61 patients [15% of complications]), missed injuries (58 patients [14% of complications]), and intravascular catheter-related complications (48 patients [12% of complications]). These complications were clinically relevant; 258 (64% of complications) resulted in a change in management, including 61 laparotomies, 52 reintubations, 41 chest tube insertions, and 19 vascular interventions.
  
  
  CONCLUSIONS
  The incidence of preventable or potentially preventable complications at an academic level I trauma center is low. These complications often require a change in management and cluster in 4 major categories (ie, unintended extubation, surgical technical failures, missed injuries, and intravascular catheter-related complications) that must be recognized as critical areas for quality improvement initiatives.
authors.affiliation: Division of Trauma Surgery and Surgical Critical Care, University of Southern California, Los Angeles, CA 90033, USA.
authors.forename: Pedro G R
authors.initials: PG
authors.lastname: Teixeira
authors.forename: Kenji
authors.initials: K
authors.lastname: Inaba
authors.forename: Ali
authors.initials: A
authors.lastname: Salim
authors.forename: Peter
authors.initials: P
authors.lastname: Rhee
authors.forename: Carlos
authors.initials: C
authors.lastname: Brown
authors.forename: Timothy
authors.initials: T
authors.lastname: Browder
authors.forename: Joseph
authors.initials: J
authors.lastname: DuBose
authors.forename: Shirley
authors.initials: S
authors.lastname: Nomoto
authors.forename: Demetrios
authors.initials: D
authors.lastname: Demetriades
mesh_terms: D000293:Adolescent; D000328:Adult; D002140:California / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D014193:Trauma Centers / Q000592:standards*; D014194:Traumatology; D014947:Wounds and Injuries / Q000150:complications* / Q000401:mortality*; D055815:Young Adult