title: A 5-year review of a trauma-trained hospitalist program for trauma patients: A matched cohort study.
abstract: BACKGROUND
  Level I trauma centers have requirements on the percentage of trauma patients admitted to either a trauma surgeon or surgical subspecialist; however, surgical resources are in steady decline. Therefore, a trauma system might better utilize its surgical resources if trained hospitalists admitted a larger percentage of mild to moderately injured trauma patients. The objective of this report is to provide a 5-year evaluation of a trauma medical service (TMED) at treating mild to moderately injured trauma patients.
  
  
  METHODS
  Adult trauma patients consecutively admitted to a Level I trauma center between January 2006 and December 2010 were analyzed. Patients admitted to trauma surgical services were matched 1:1 to those admitted to TMED, via propensity scores. Paired t tests examined differences in hospital duration of stay (DOS), and exact conditional logistic regression examined differences in the odds of having a delayed diagnosis, developing a complication, and dying.
  
  
  RESULTS
  Of 1,202 TMED patients, 494 were matched; matched TMED patients had similar patient outcomes to nonmatched TMED patients. There were no differences between study groups in the mean hospital DOS, the proportion having a delayed diagnosis, or in the odds of dying in the hospital (P > .05 for all). The TMED group had a nominally higher complication rate (P = .12) owing to a higher rate of urinary tract infections.
  
  
  CONCLUSIONS
  Since its inception, the TMED service has successfully and safely treated mild to moderately injured trauma patients, and decreased the dependency on trauma surgical services. Trauma centers might utilize declining surgical services more efficiently with the addition of trauma medical hospitalists.
authors.affiliation: Trauma Research Department, Swedish Medical Center, Englewood, CO, USA.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Orlando
authors.forename: Kristin
authors.initials: K
authors.lastname: Salottolo
authors.forename: Phyllis
authors.initials: P
authors.lastname: Uribe
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Howell
authors.forename: Denetta S
authors.initials: DS
authors.lastname: Slone
authors.forename: David
authors.initials: D
authors.lastname: Bar-Or
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D015994:Incidence; D007902:Length of Stay; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D015397:Program Evaluation; D012189:Retrospective Studies; D015996:Survival Rate; D014193:Trauma Centers / Q000639:trends*; D015599:Trauma Severity Indices; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D055815:Young Adult