Trauma Centers Boost Head Injury Survival

Head-injury patients who are transferred to level I trauma centers are more likely to survive than those transferred to level II facilities, according to a new study published in the journal Health Services Research.

Researchers analyzed data on 542 patients sent from 31 rural trauma centers to level I and II trauma centers between 1991 and 1994. The study population included patients with simple concussions as well as patients with fatal traumatic brain injury. Mortality was based on death during hospitalization or within 30 days of discharge.

The research team found that mortality dropped 10% among patients transferred to level II centers. Level I centers provide comprehensive trauma care, including trauma doctors in every specialty who are immediately available, and must have resuscitation, neuroradiology, and hemodialysis technology. Also, they have training programs and are required to treat 1,200 injured patients or 240 major trauma patients annually. Level II centers have less-stringent volume performance standards and are not required to have teaching and research programs.

"Our results suggest that some of the operational and philosophical differences in the acute management of head-injured persons between level I and level II centers may actually translate into improved survival among patients initially presenting to rural hospitals and transferred to level I centers versus those transferred to level II centers,” noted co-author Craig Newgard, M.D., assistant professor of emergency medicine, Oregon Health & Science University (Portland, USA).






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