Outcomes of adult trauma patients admitted to trauma centers in Pennsylvania, 2000-2009.
OBJECTIVE
To examine longitudinal trends in mortality for injured patients admitted to trauma centers.


METHODS
Retrospective cohort design of 208 866 patients admitted to level I or level II trauma centers in Pennsylvania between 2000 and 2009 using the Pennsylvania Trauma Outcome Study database. Multivariate logistic regression was used to estimate the temporal trend for in-hospital mortality.


METHODS
Patients were stratified by injury severity to estimate mortality trends in patients with low-severity, moderate, severe, and very severe injuries.


RESULTS
Comparing 2000-2001 data with 2008-2009 data, the odds of mortality decreased by 29% (adjusted odds ratio [AOR] = 0.71; 95% CI, 0.59-0.85) and the odds of major complications decreased by 32% (AOR = 0.68; 95% CI, 0.57-0.81). Between 2000 and 2009, the mortality rate for patients admitted with moderate trauma decreased by 42% (AOR = 0.58; 95% CI, 0.46-0.71) and the mortality rate for patients with severe trauma decreased by 51% (AOR = 0.49; 95% CI, 0.40-0.60). Mortality rates for patients admitted with mild trauma or with very severe trauma did not change significantly during this period.


CONCLUSIONS
In-hospital mortality and major complications for adult trauma patients admitted to level I or level II trauma centers declined by 30% between 2000 and 2009. After stratifying patients by injury severity, the mortality rate for patients presenting with moderate or severe injuries declined by 40% to 50%, whereas mortality rates remained unchanged in patients with the least severe or the most severe injuries.
Department of Anesthesiology, University of Rochester Medical Center, 601 Elmwood Ave, PO Box 604, Rochester, NY 14642, USA. laurent_glance@urmc.rochester.edu
Laurent G
LG
Glance
Turner M
TM
Osler
Dana B
DB
Mukamel
Andrew W
AW
Dick
D000328:Adult; D015600:Glasgow Coma Scale; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D015601:Injury Severity Score; D016015:Logistic Models; D017063:Outcome Assessment, Health Care; D010414:Pennsylvania; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000150:complications / Q000401:mortality*