J Trauma
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Recent papers from established trauma centers reported average elapsed times from emergency department (ED) admission to the operating room (OR) of greater than 100 minutes for patients judged to be in immediate need of surgery. This study was undertaken to determine whether patients treated at an institution desiring level II trauma center designation in a geographic area with a low incidence of penetrating trauma suffered any adverse effects because of lack of a 24-hour in-house OR staff. Trauma registry data at The Stamford Hospital, a suburban community teaching hospital without OR nursing staff in-house at night, were reviewed and compared with data from three affiliated level I trauma centers and with established national standards using TRISS methodology. ⋯ No unexpected adverse outcomes could be ascribed to the lack of 24-hour OR staffing in this setting. The estimated cost of providing additional OR staffing is $145,000 per year. Since times to the OR and outcomes were similar to those at level I centers, this expense may not be warranted.