Mortality rate and major complications have declined among adult trauma patients cared for in trauma centers
Trauma is the leading cause of death in people under the age of 65. Greater access to level I and level II trauma centers has helped reduce death and complications in adult trauma patients. In fact, a new study found that in-hospital mortality rates and major complications for adult trauma patients admitted to level I or level II trauma centers declined 30 percent between 2000 and 2009 in Pennsylvania. Mortality rates and major complications declined even more (40 to 50 percent) for patients with moderate or severe injuries. Mortality rates remained unchanged for patients with the least severe or most severe injuries. Those are the findings of a study of 208,866 patients admitted to level I or level II trauma centers in Pennsylvania that compared 2000–2001 data with 2008–2009 data.
The median age of patients increased from 44 to 52 years during the study period. While low-severity trauma decreased from 34.5 percent to 30 percent, severe trauma increased from 14.5 percent to 19.9 percent. Other prevalence increases were noted for blunt trauma and low falls. However, there were decreases for motor vehicle crashes (30.9 percent to 21 percent) and gunshot wounds (6.8 percent to 5 percent). Overall, the mortality rate declined by 29 percent and complications decreased by 32 percent. Mortality rates for patients with moderate and severe trauma dropped by 42 percent and 51 percent, respectively. In the case of patients with the least severe or more severe injuries, mortality rates did not improve as significantly as other patient groups. The study was supported by AHRQ (HS16737).
See "Outcomes of adult trauma patients admitted to trauma centers in Pennsylvania, 2000-2009," by Laurent G. Glance, M.D., Turner M. Osler, M.D., Dana B. Mukamel, Ph.D., and Andrew W. Dick, Ph.D., in the August 2012 Archives of Surgery 147(8), pp. 732-737.