Abstract：
BACKGROUND:This study analyzes trends in hospitalization and outcome for adult, elderly, and pediatric trauma victims in the Florida Trauma System (FTS) from 1991 to 2003, during which time the number of centers nearly doubled from 11 to 20. METHODS:Administrative data was queried for all admissions with at least one trauma related discharge. Patients were stratified by age as pediatric (age, 0 to 15 years), adult (age, 16 to 64 years), or elderly (age, >64 years). Volume of admissions, severity, and mortality were analyzed over time. A logistic regression model was used to test the existence of an organizational experience curve after the designation of a new trauma center. RESULTS:Injury-related hospitalizations increased for the elderly, stayed the same for adults, and declined for children. As the system matured, a larger percentage of victims, particularly the most severely injured, were triaged to trauma centers, indicating more effective triage. In contrast to adults and pediatric patients, the majority of elderly trauma victims were managed at non-trauma centers. The trauma mortality rate per 1,000 population among the elderly increased during the study period (P < .01). Multivariate analysis indicated that for adult and pediatric victims it took up to 3 years after the designation of trauma center status before the odds of mortality reached parity with that of established centers. CONCLUSIONS:The FTS has grown with its population and has matured to treat a larger percentage of trauma victims. Trauma victims transported to established trauma centers (4+ years) have a survival advantage compared to their counterparts transported to newly created centers. The reduction in the odds of mortality does not occur immediately after trauma center designation.
journal_name
Surgeryjournal_title
Surgeryauthors
Pracht EE,Langland-Orban B,Tepas JJ 3rd,Celso BG,Flint Ldoi
10.1016/j.surg.2006.01.012subject
Has Abstractpub_date
2006-07-01 00:00:00pages
34-43issue
1eissn
0039-6060issn
1532-7361pii
S0039-6060(06)00062-6journal_volume
140pub_type
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