title: Implementing acute care surgery at a level I trauma center: 1-year prospective evaluation of the impact of this shift on trauma volumes and outcomes.
abstract: BACKGROUND
  The purpose of this study was to evaluate the impact of the transition to acute care surgery (ACS) on trauma volumes and outcomes.
  
  
  METHODS
  All admissions from 2 1-year periods from June 2008 to May 2010 (1 year before ACS and 1 year after ACS) to the LAC+USC Medical Center were prospectively collected. In anticipation of this change, trauma patient demographics, clinical data, and outcomes (trauma volume and preventable and potentially preventable deaths and complications) were prospectively collected.
  
  
  RESULTS
  Before ACS, there were 5,378 trauma admissions. After ACS, there were 5,726 (66.5%) trauma and 2,886 (33.5%) nontrauma admissions. There were no demographic or clinical differences between trauma patients in the 2 groups. There was no significant difference in overall mortality (3.8% before ACS vs 3.3% after ACS, P = .292). Similarly, there were no differences in the rates of preventable and potentially preventable deaths or complications observed (1.2% vs 1.0%, P = .374) during the study period.
  
  
  CONCLUSIONS
  Despite a 60% increase in total patient volume and a 233% increase in operative volume over the study period, the addition of emergency surgery to a trauma service did not compromise trauma patient outcomes.
authors.affiliation: Division of Trauma, Critical Care and Emergency Surgery, University of Arizona, Tucson, AZ, USA.
authors.forename: Bernardino C
authors.initials: BC
authors.lastname: Branco
authors.forename: Kenji
authors.initials: K
authors.lastname: Inaba
authors.forename: Lydia
authors.initials: L
authors.lastname: Lam
authors.forename: Agathoklis
authors.initials: A
authors.lastname: Konstantinidis
authors.forename: Andrew L
authors.initials: AL
authors.lastname: Tang
authors.forename: Peep
authors.initials: P
authors.lastname: Talving
authors.forename: Ali
authors.initials: A
authors.lastname: Salim
authors.forename: Demetrios
authors.initials: D
authors.lastname: Demetriades
mesh_terms: D000328:Adult; D000368:Aged; D001130:Arizona; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D011446:Prospective Studies; D013514:Surgical Procedures, Operative / Q000401:mortality / Q000706:statistics & numerical data*; D014193:Trauma Centers / Q000458:organization & administration* / Q000706:statistics & numerical data*; D016896:Treatment Outcome