The Impact of a New Trauma Center on an Existing Nearby Trauma Center

Simón, Ronald; Stone, Melvin E.; Cucuzzo, Janet

doi:10.1097/ta.0b013e31818cae0c

Cited by 18 publications

(13 citation statements)

References 9 publications

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“…19 Recent studies have demonstrated that patients treated at established centers may have survival advantages over those managed at newly created centers, 20 and a new trauma center may have potential negative impact on a nearby established one. 21 Taken together, it is unlikely that HK will benefit from designating more trauma centers. Indeed, an important question is whether service may be consolidated to concentrate clinical experience in fewer centers.…”

Section: Discussionmentioning

confidence: 98%

The First 5 Years Since Trauma Center Designation in the Hong Kong Special Administrative Region, People's Republic of China

Leung

Chang

Cheung

et al. 2011

Journal of Trauma: Injury, Infection &Amp; Critical Care

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The case-mix of trauma patients in the HKSAR is comparable with that of the MTOS. A young trauma system relatively unburdened by dissimilar reimbursement and patient access issues may achieve significant improvement and satisfactory patient outcomes. Our findings may serve as a useful benchmark for HK and other Southeast Asian cities and trauma systems to establish local coefficients for future evaluations.

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Section: Discussionmentioning

confidence: 98%

The First 5 Years Since Trauma Center Designation in the Hong Kong Special Administrative Region, People's Republic of China

Leung

Chang

Cheung

et al. 2011

Journal of Trauma: Injury, Infection &Amp; Critical Care

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“…Other studies have both supported 2–4, 26 and refuted 6, 7, 9 the premise that increased trauma center volume results in better outcomes. Our results showed a broad effect on survival in those with severe injuries.…”

Section: Discussionmentioning

confidence: 99%

Increased Trauma Center Volume Is Associated With Improved Survival After Severe Injury

et al. 2014

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Structured Abstract OBJECTIVE The Resuscitation Outcomes Consortium (ROC) is a network of 11 centers and 60 hospitals conducting emergency care research. For many procedures, high volume centers demonstrate superior outcomes versus low volume centers. This remains controversial for trauma center outcomes. This study investigated the relationship of trauma center volume on outcome. METHODS This study was a secondary analysis of prospectively collected data from the ROC multicenter out-of-hospital Hypertonic Saline Trial in patients with GCS ≤ 8 (traumatic brain injury [TBI]) or SBP ≤ 90 and pulse ≥ 110 (shock). Regression analyses evaluated associations between trauma volume and the following outcomes: 24 hour mortality, 28 day mortality, ventilator free days (VFD), Multiple Organ Dysfunction Scale (MODS) incidence, worst MODS score, and poor 6 month Glasgow outcome scale extended. RESULTS 2070 patients were analyzed: 1251 in the TBI cohort and 819 in the shock cohort. Overall, 24-hour and 28-day mortality were 16% and 25%, respectively. For every increase of 500 trauma center admissions, there was a 7% decreased odds of both 24-hour and 28-day mortalities for all patients. As trauma center volume increased, non-organ dysfunction complications increased, VFD increased and worst MODS score decreased. The associations with higher trauma center volume were similar for the TBI cohort, including better neurologic outcomes at 6 months, but not for the shock cohort. CONCLUSIONS Increased trauma center volume was associated with increased survival, more ventilator free days and less severe organ failure. Trauma system planning and implementation should avoid unnecessary duplication of services.

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“…We will develop a rigorous systematic search strategy with a health sciences librarian who has systematic review experience using published guidelines of The Cochrane Collaboration (see Additional file 2 for a preliminary version) [16]. The strategy will be developed for MEDLINE and EMBASE using keywords and MeSH (MEDLINE) or EMTREE (EMBASE).…”

Section: Methodsmentioning

confidence: 99%

Impact of trauma system structure on injury outcomes: a systematic review protocol

Moore

Champion²,

O’Reilly

et al. 2017

Syst Rev

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BackgroundInjury represents one of the greatest public health challenges of our time with over 5 million deaths and 100 million people temporarily or permanently disabled every year worldwide. The effectiveness of trauma systems in decreasing injury mortality and morbidity has been well demonstrated. However, the organisation of trauma care varies significantly across trauma systems and we know little about which components of trauma systems contribute to their effectiveness. The objective of the study described in this protocol is to systematically review evidence of the impact of trauma system components on clinically significant outcomes including mortality, function and disability, quality of life, and resource utilization.MethodsWe will perform a systematic review of studies evaluating the association between at least one trauma system component (e.g. accreditation by a central agency, interfacility transfer agreements) and at least one injury outcome (e.g. mortality, disability, resource use). We will search MEDLINE, EMBASE, COCHRANE central, and BIOSIS/Web of Knowledge databases, thesis holdings, key injury organisation websites and conference proceedings for eligible studies. Pairs of independent reviewers will evaluate studies for eligibility and extract data from included articles. Methodological quality will be evaluated using elements of the ROBINS-I tool and the Cochrane risk of bias tool for non-randomized and randomized studies, respectively. Strength of evidence will be evaluated using the GRADE tool.DiscussionWe expect to advance knowledge on the components of trauma systems that contribute to their effectiveness. This may lead to recommendations on trauma system structure that will help policy-makers make informed decisions as to where resources should be focused. The review may also lead to specific recommendations for future research efforts.Systematic review registrationThis protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) on 28-06-2016. PROSPERO 2016:CRD42016041336 Available from http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016041336.Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-017-0408-8) contains supplementary material, which is available to authorized users.

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The Impact of a New Trauma Center on an Existing Nearby Trauma Center

Cited by 18 publications

References 9 publications

The First 5 Years Since Trauma Center Designation in the Hong Kong Special Administrative Region, People's Republic of China

The First 5 Years Since Trauma Center Designation in the Hong Kong Special Administrative Region, People's Republic of China

Increased Trauma Center Volume Is Associated With Improved Survival After Severe Injury

Impact of trauma system structure on injury outcomes: a systematic review protocol

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