title: Full time trauma service leads to improved Level III trauma center outcomes.
abstract: BACKGROUND
  Level III trauma centers are an effective component of a healthy trauma system. This study examined the effectiveness over time of a Level III trauma center in a predominately rural region.
  
  
  METHODS
  For analysis, the data were divided into 2 equal time spans: an early period (1997-2002) and a late period (2003-2008). A dedicated trauma service was implemented in 2003.
  
  
  RESULTS
  A total of 8,689 patient outcomes were analyzed. In those patients with an injury severity score of 15 or less, 49 of 3,307 (1.5%) patients died in the early period, and 74 of 4,244 (1.7%) died in the late period (P = .40). In those with an injury severity score greater than 15, 66 of 402 patients (16.4%) died in the early period, whereas 81 of 736 (11.0%) patients died in the late period (P = .01). Despite the increased injury severity, overall mortality rates remained unchanged.
  
  
  CONCLUSIONS
  Implementation of a full-time trauma service resulted in improved outcomes including a 33% mortality reduction in the severely injured.
authors.affiliation: Medical Center Hospital, Odessa, TX 79761, USA. cdaniel@echd.org
authors.forename: Craig O
authors.initials: CO
authors.lastname: Daniel
authors.forename: T A
authors.initials: TA
authors.lastname: West
authors.forename: Phyllis S
authors.initials: PS
authors.lastname: Craig-Blanco
authors.forename: John G
authors.initials: JG
authors.lastname: Myers
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Stewart
mesh_terms: D000328:Adult; D005260:Female; D006780:Hospitals, Rural; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D014193:Trauma Centers / Q000458:organization & administration*; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000209:etiology / Q000401:mortality / Q000628:therapy*