title: Sustainable Effectiveness of Applying Trauma Team Activation in Managing Trauma Patients in the Emergency Department.
abstract: OBJECTIVE
  To determine long term effectiveness of trauma team activation criteria by measuring emergency department length of stay (EDLOS) and 28-day mortality.
  
  
  METHODS
  A 3-year retrospective cohort study conducted in adult trauma patients who met one of the trauma team activation criteria (shock, penetrating torso injury, post traumatic arrest, respiratory rate of less than 12 or more than 30, and pulse rate of more than 120). Specific demographic data, physiologic parameters, EDLOS, injury severity score (ISS), and 28-day mortality were prospectively recorded into the Trauma Registry database. Multiple logistic regression analysis was used to determine factors affecting mortality. The Institutional Review Board approval was obtained prior to undertaking the project.
  
  
  RESULTS
  Two hundred eighty two patients with a mean age of35.1 years old were eligible. The median ISS was 25 (range, 13-30). The median EDLOS was 85 minutes (range, 50-135) and the 28-day mortality rate was 46.5%. The mean age was 31.7 years in the survival group and 38.7 years in the fatal group (p = 0.001). The median ISS was 17 in the survival group and 26 in the fatal group (p = 0.000) and the median EDLOS was 110 minutes in the survival group and 82 minutes in the fatal group (p = 0.034). When compared to data prior to the TTA application, the median time of EDLOS improvedsustainably from 184 to 85 minutes (p = 0.000) and the mortality rate decreased from 66.7% to 46.5% (p = 0.057). The parameters affecting patient mortality were older age, high ISS, and shorter EDLOS.
  
  
  CONCLUSIONS
  Trauma team activation criteria significantly improved acute trauma care in the emergency department and decreased mortality.
authors.forename: Prasit
authors.initials: P
authors.lastname: Wuthisuthimethawee
authors.forename: Michael S
authors.initials: MS
authors.lastname: Molloy
authors.forename: Gregory R
authors.initials: GR
authors.lastname: Ciottone
mesh_terms: D000293:Adolescent; D000328:Adult; D015331:Cohort Studies; D004632:Emergency Medical Services / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D004636:Emergency Service, Hospital / Q000592:standards* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013785:Thailand; D055815:Young Adult