• Chih-Yuan Fu, Francesco Bajani, Leah Tatebe, Caroline Butler, Frederic Starr, Andrew Dennis, Matthew Kaminsky, Thomas Messer, Victoria Schlanser, Kristina Kramer, Stathis Poulakidas, Chi-Tung Cheng, Justin Mis, and Faran Bokhari.
• From the Department of Trauma and Burn Surgery (C-Y.F., F.B., L.T., C.B., F.S., A.D., M.K., T.M., V.S., K.K., S.P. C-T.C., J.M., F.B.), Stroger Hospital of Cook County, Rush University, Chicago, Illinois; and Department of Trauma and Emergency Surgery (C-Y.F., C-T.C.), Chang Gung Memorial Hospital, Chang Gung University, Taoyuan City, Taiwan.
• J Trauma Acute Care Surg. 2019 Jun 1; 86 (6): 961-966.

BackgroundThe recognition of the relationship between volume and outcomes led to the regionalization of trauma care. The relationship between trauma mechanism-subtype and outcomes has yet to be explored. We hypothesized that trauma centers with a high volume of penetrating trauma patients might be associated with a higher survival rate for penetrating trauma patients.MethodsA retrospective cohort analysis of penetrating trauma patients presenting between 2011 and 2015 was conducted using the National Trauma Database and the trauma registry at the Stroger Cook County Hospital. Linear regression was used to determine the relationship between mortality and the annual volume of penetrating trauma seen by the treating hospital.ResultsNationally, penetrating injuries account for 9.5% of the trauma cases treated. Patients treated within the top quartile penetrating-volume hospitals (≥167 penetrating cases per annum) are more severely injured (Injury Severity Score: 8.9 vs. 7.7) than those treated at the lowest quartile penetrating volume centers (<36.6 patients per annum). There was a lower mortality rate at institutions that treated high numbers of penetrating trauma patients per annum. A penetrating trauma mortality risk adjustment model showed that the volume of penetrating trauma patients was an independent factor associated with survival rate.ConclusionTrauma centers with high penetrating trauma patient volumes are associated with improved survival of these patients. This association with improved survival does not hold true for the total trauma volume at a center but is specific to the volume of the penetrating trauma subtype.Level Of EvidencePrognostic/Epidemiology Study, Level-III; Therapeutic/Care Management, Level IV.

14 keywords...

hide…