PMID- 27032008
OWN - NLM
STAT- MEDLINE
DCOM- 20170629
LR  - 20191210
IS  - 2163-0763 (Electronic)
IS  - 2163-0755 (Linking)
VI  - 81
IP  - 1
DP  - 2016 Jul
TI  - Performance of a regional trauma network: A state-wide analysis.
PG  - 190-5
LID - 10.1097/TA.0000000000001067 [doi]
AB  - BACKGROUND: The Northern Ohio Trauma System (NOTS), established in 2010, is a 
      collaborative regional trauma system composed of one level I and several 
      lower-level trauma centers (TCs) across multiple hospital systems. Mortalities 
      between counties in NOTS and other Ohio counties were compared to assess NOTS 
      performance. METHODS: State trauma registry was analyzed for patients 15 years or 
      older from 2006 to 2012. Mortality change over time was assessed by comparing all 
      counties before and after NOTS establishment. Two analyses were done in the 
      post-NOTS period: (1) a county analysis, comparing Cuyahoga County, the county 
      containing NOTS level I TC (L1TC), with other counties containing L1TCs and (2) a 
      regional analysis, comparing Cuyahoga and its adjacent counties (i.e., the NOTS 
      region) with other L1TC containing regions. The following subgroups were included 
      a priori: Injury Severity Score 15 or greater, age 65 years or older, and trauma 
      mechanism. RESULTS: A total of 178,143 patients were analyzed. Cuyahoga was the 
      only county that had a decrease in mortality for both the overall group and all 
      subgroups over time (all p < 0.05). Both the county and regional analyses showed 
      that the overall NOTS patients were 1 to 4 years older (p < 0.05), had similar or 
      higher Injury Severity Score (p < 0.05), and were treated more often at 
      lower-level TCs (p < 0.001). County analysis demonstrated that Cuyahoga County 
      had approximately 1% lower mortality in geriatrics patients compared with 
      non-NOTS counties. Regional analysis showed lower mortality in the NOTS region 
      for the overall patient group, as well as geriatric and blunt injuries subgroups. 
      CONCLUSIONS: Cuyahoga was the only county in Ohio that had significant mortality 
      reduction for all patient groups over time. Trauma system regionalization was 
      associated with greater utilization of lower-level TCs and lower patient 
      mortality. These findings suggest that a collaborative regional trauma system may 
      be more important than the number of L1TC in an area. LEVEL OF EVIDENCE: 
      Therapeutic/care management study, level IV.
FAU - He, Jack C
AU  - He JC
AD  - Department of Surgery (J.C.H., L.A.L., J.A.C.), MetroHealth Medical Center, Case 
      Western Reserve University School of Medicine, Cleveland, Ohio; and Case Western 
      Reserve University School of Medicine (N.S), Cleveland, Ohio; Northern Ohio 
      Trauma System (D.L.A.), Cleveland, Ohio.
FAU - Kreiner, Laura A
AU  - Kreiner LA
FAU - Sajankila, Nitin
AU  - Sajankila N
FAU - Allen, Debra L
AU  - Allen DL
FAU - Claridge, Jeffrey A
AU  - Claridge JA
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Trauma Acute Care Surg
JT  - The journal of trauma and acute care surgery
JID - 101570622
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Female
MH  - Humans
MH  - Injury Severity Score
MH  - Male
MH  - Middle Aged
MH  - Ohio/epidemiology
MH  - *Outcome and Process Assessment, Health Care
MH  - Regional Medical Programs/*organization & administration
MH  - Registries
MH  - Trauma Centers/*organization & administration
MH  - Wounds and Injuries/*mortality/*therapy
EDAT- 2016/04/01 06:00
MHDA- 2017/07/01 06:00
CRDT- 2016/04/01 06:00
PHST- 2016/04/01 06:00 [entrez]
PHST- 2016/04/01 06:00 [pubmed]
PHST- 2017/07/01 06:00 [medline]
AID - 10.1097/TA.0000000000001067 [doi]
PST - ppublish
SO  - J Trauma Acute Care Surg. 2016 Jul;81(1):190-5. doi: 10.1097/TA.0000000000001067.