Does Trauma Room Duration Affect Patient Outcome in a Level I Trauma Center?

Ernstberger A, Treffer D, Loibl M, Hilber F, Nerlich M and Angerpointner K

Department of Trauma Surgery, University Hospital Regensburg, Germany

^*Correspondance to: Antonio Ernstberger 

 PDF  Full Text DOI: 10.25107/2474-1647.2176

Abstract

Background: Trauma is the leading cause of death and morbidity in younger people aged 15-29 years worldwide. Implementation of guidelines, care algorithms, Standard Operating Procedures (SOPs) or white books aim at improving quality and safety of trauma care. Therefore, time is a common item to evaluate the quality of trauma care (e.g. the duration of trauma room care or the duration of certain interventions). This study evaluates the influence of the duration of trauma room care on patient outcome at a well-trained level I trauma center.Materials and
Methods: Study population: 382 (ISS > 16) patients primarily admitted to the trauma room of a level I trauma center were included in a 64 month period. The study population was grouped according to the prognostic RISC-Score for expected fatality (expected fatality rate: RISCgroup 1: [0%-5%], RISC-group 2: [5%-50%], RISC-group 3: [50%-100%]). Moreover, each RISCgroup was sub-grouped according to the total duration of trauma room treatment (SHORT-subgroup:≥ median trauma room time).Results: Comparative analysis demonstrated shortest trauma room times in cases with expected fatality of ≥ 50% (total trauma room duration: RISC-group 1: 66.7 ± 28.2 min, RISC-group 2: 69.1 ±29.1 min, RISC-group 3: 58.0 ± 32.2 min; p=0.006). A second trauma room phase (after primary trauma room phase and CT-scan) was associated with an increase of the interventions performed and a prolonged trauma room time. With regard to hospital mortality, no significant difference was found in the SHORT- versus LONG-sub-group. The Standard Mortality Ratio (SMR) of the study sample (SMR=0.63) and all sub-groups were lower compared to the 2007 - 2012 cases of the Trauma Register DGU® (trauma registry of the German Trauma Society).Conclusion: This study indicates that the individual duration of trauma room care in the optimized setting of a level I trauma center does not impact on patient outcome indicators. On the contrary, it reflects a financially and resource demanding trauma room care, that has to be provided for a more complex trauma patient care.

Keywords

Trauma room; Trauma center; Multiple trauma; ATLS; DGU; Traumanetzwerk; RISC

Cite the article

Ernstberger A, Treffer D, Loibl M, Hilber F, Nerlich M, Angerpointner K. Does Trauma Room Duration Affect Patient Outcome in a Level I Trauma Center? Clin Surg. 2018; 3: 2176.