Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Mortality Reduction in Major Trauma Patients after Establishment of a Level I Trauma Center in Korea: A Single-Center Experience

  • Roh, Young Il (Department of Emergency Medicine, Yonsei University Wonju College of Medicine) ;
  • Kim, Hyung Il (Department of Emergency Medicine, Yonsei University Wonju College of Medicine) ;
  • Cha, Yong Sung (Department of Emergency Medicine, Yonsei University Wonju College of Medicine) ;
  • Cha, Kyoung-Chul (Department of Emergency Medicine, Yonsei University Wonju College of Medicine) ;
  • Kim, Hyun (Department of Emergency Medicine, Yonsei University Wonju College of Medicine) ;
  • Lee, Kang Hyun (Department of Emergency Medicine, Yonsei University Wonju College of Medicine) ;
  • Hwang, Sung Oh (Department of Emergency Medicine, Yonsei University Wonju College of Medicine) ;
  • Kim, Oh Hyun (Department of Emergency Medicine, Yonsei University Wonju College of Medicine)
  • Received : 2017.10.20
  • Accepted : 2017.10.26
  • Published : 2017.12.30
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Abstract

Purpose: Trauma systems have been shown to decrease injury-related mortality. The present study aimed to compare the mortality rates of patients with major trauma (injury severity score >15) treated before and after the establishment of a level I trauma center. Methods: During this 20-month study, participants were divided into pre-trauma center and trauma center groups, and trauma and injury severity score (TRISS) method was used to compare mortality rates during 10-month periods before and after the establishment of the trauma center (October 2013 to July 2014 vs. October 2014 to July 2015). Results: Of the 541 total participants, 278 (51.5%) visited after the establishment of the trauma center. The Z and W statistics indicated better outcomes in the trauma center group than in the pre-trauma center group (Z statistic, 2.635 vs. -0.700; W statistic, 4.640). The trauma center group also exhibited meaningful reductions in the time interval from the emergency department (ED) visit to emergency surgery (118.0 minutes vs. 142.5 minutes, p=0.020) and the interval from the ED visit to intensive care unit admission (202.0 minutes vs. 259.0 minutes, p=0.035) relative to the pre-trauma center group. Conclusions: The TRISS and multivariate analysis revealed significant improvements in survival rates in the trauma center group, compared to the pre-trauma center group.

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