• Craig O Daniel, T A West, Phyllis S Craig-Blanco, John G Myers, and Ronald M Stewart.
• Medical Center Hospital, Odessa, TX 79761, USA. cdaniel@echd.org
• Am. J. Surg. 2010 Dec 1; 200 (6): 734-9; discussion 739-40.

BackgroundLevel III trauma centers are an effective component of a healthy trauma system. This study examined the effectiveness over time of a Level III trauma center in a predominately rural region.MethodsFor analysis, the data were divided into 2 equal time spans: an early period (1997-2002) and a late period (2003-2008). A dedicated trauma service was implemented in 2003.ResultsA total of 8,689 patient outcomes were analyzed. In those patients with an injury severity score of 15 or less, 49 of 3,307 (1.5%) patients died in the early period, and 74 of 4,244 (1.7%) died in the late period (P = .40). In those with an injury severity score greater than 15, 66 of 402 patients (16.4%) died in the early period, whereas 81 of 736 (11.0%) patients died in the late period (P = .01). Despite the increased injury severity, overall mortality rates remained unchanged.ConclusionsImplementation of a full-time trauma service resulted in improved outcomes including a 33% mortality reduction in the severely injured.Copyright © 2010 Elsevier Inc. All rights reserved.

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