• Laurent G Glance, Turner M Osler, Dana B Mukamel, and Andrew W Dick.
• Department of Anesthesiology, University of Rochester Medical Center, 601 Elmwood Ave, PO Box 604, Rochester, NY 14642, USA. laurent_glance@urmc.rochester.edu
• Arch Surg. 2012 Aug 1;147(8):732-7.

ObjectiveTo examine longitudinal trends in mortality for injured patients admitted to trauma centers.Design, Setting, And ParticipantsRetrospective 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.Main Outcome MeasuresPatients were stratified by injury severity to estimate mortality trends in patients with low-severity, moderate, severe, and very severe injuries.ResultsComparing 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.ConclusionsIn-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.

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