An analysis of the association of trauma centers with per capita hospitalizations and death rates from injury

R. Rutledge, S. M. Fakhry, A. Meyer, G. F. Sheldon, C. C. Baker, R. E. Condon, C. L. Rice, F. R. Lewis, Donald Trunkey, B. A. Pruitt, R. S. Rhodes, A. H. Harken, N. Lempert

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

Objective: This study used population-based data bases to assess the association of trauma centers with per capita county hospitalization and trauma death rates in the State of North Carolina. Summary Background Data: The current study extended previous work using two North Carolina data bases to assess the association of the presence of a trauma center with per capita county trauma death rates. Methods: Data on per capita county trauma hospitalizations and deaths were obtained from the state hospital discharge data base and the North Carolina Medical Examiner's data base. Bivariate and multivariate analysis techniques were used. The dependent variables of interest were prehospital, hospital, and total trauma death rates and hospitalization rates for injury. Results: Bivariate analysis identified a number of factors associated with per capita county hospitalizations and trauma death rates. These included the per cent unemployment, racial distribution, county alcohol tax receipts, and advanced life support certified emergency medical services providers. The per capita trauma death rates were significantly lower in counties with trauma centers compared with those without trauma centers (4.0 ± 0.5 and 5.0 ± 1.1 deaths per 10,000 population, p = 0.0001, respectively). The per capita hospitalizations for trauma were also lower in counties with trauma centers. Multivariate modeling showed that the presence of a trauma center and advanced life support providers were the best predictors of decreased per capita county trauma death rates. Conclusions: The study showed that the presence of a trauma center and advanced life support training were the two medical system factors that were the best predictors of the per capita county prehospital and total trauma death rates. These findings are consistent with the hypothesis that trauma centers are associated with a decrease in trauma death rates.

Original languageEnglish (US)
Pages (from-to)512-524
Number of pages13
JournalAnnals of Surgery
Volume218
Issue number4
StatePublished - 1993
Externally publishedYes

Fingerprint

Trauma Centers
Hospitalization
Mortality
Wounds and Injuries
Databases
Training Support
Coroners and Medical Examiners
State Hospitals
Unemployment
Taxes
Emergency Medical Services
Population
Multivariate Analysis
Alcohols

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Rutledge, R., Fakhry, S. M., Meyer, A., Sheldon, G. F., Baker, C. C., Condon, R. E., ... Lempert, N. (1993). An analysis of the association of trauma centers with per capita hospitalizations and death rates from injury. Annals of Surgery, 218(4), 512-524.

An analysis of the association of trauma centers with per capita hospitalizations and death rates from injury. / Rutledge, R.; Fakhry, S. M.; Meyer, A.; Sheldon, G. F.; Baker, C. C.; Condon, R. E.; Rice, C. L.; Lewis, F. R.; Trunkey, Donald; Pruitt, B. A.; Rhodes, R. S.; Harken, A. H.; Lempert, N.

In: Annals of Surgery, Vol. 218, No. 4, 1993, p. 512-524.

Research output: Contribution to journalArticle

Rutledge, R, Fakhry, SM, Meyer, A, Sheldon, GF, Baker, CC, Condon, RE, Rice, CL, Lewis, FR, Trunkey, D, Pruitt, BA, Rhodes, RS, Harken, AH & Lempert, N 1993, 'An analysis of the association of trauma centers with per capita hospitalizations and death rates from injury', Annals of Surgery, vol. 218, no. 4, pp. 512-524.
Rutledge R, Fakhry SM, Meyer A, Sheldon GF, Baker CC, Condon RE et al. An analysis of the association of trauma centers with per capita hospitalizations and death rates from injury. Annals of Surgery. 1993;218(4):512-524.
Rutledge, R. ; Fakhry, S. M. ; Meyer, A. ; Sheldon, G. F. ; Baker, C. C. ; Condon, R. E. ; Rice, C. L. ; Lewis, F. R. ; Trunkey, Donald ; Pruitt, B. A. ; Rhodes, R. S. ; Harken, A. H. ; Lempert, N. / An analysis of the association of trauma centers with per capita hospitalizations and death rates from injury. In: Annals of Surgery. 1993 ; Vol. 218, No. 4. pp. 512-524.
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AU - Meyer, A.

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AU - Baker, C. C.

AU - Condon, R. E.

AU - Rice, C. L.

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AU - Harken, A. H.

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N2 - Objective: This study used population-based data bases to assess the association of trauma centers with per capita county hospitalization and trauma death rates in the State of North Carolina. Summary Background Data: The current study extended previous work using two North Carolina data bases to assess the association of the presence of a trauma center with per capita county trauma death rates. Methods: Data on per capita county trauma hospitalizations and deaths were obtained from the state hospital discharge data base and the North Carolina Medical Examiner's data base. Bivariate and multivariate analysis techniques were used. The dependent variables of interest were prehospital, hospital, and total trauma death rates and hospitalization rates for injury. Results: Bivariate analysis identified a number of factors associated with per capita county hospitalizations and trauma death rates. These included the per cent unemployment, racial distribution, county alcohol tax receipts, and advanced life support certified emergency medical services providers. The per capita trauma death rates were significantly lower in counties with trauma centers compared with those without trauma centers (4.0 ± 0.5 and 5.0 ± 1.1 deaths per 10,000 population, p = 0.0001, respectively). The per capita hospitalizations for trauma were also lower in counties with trauma centers. Multivariate modeling showed that the presence of a trauma center and advanced life support providers were the best predictors of decreased per capita county trauma death rates. Conclusions: The study showed that the presence of a trauma center and advanced life support training were the two medical system factors that were the best predictors of the per capita county prehospital and total trauma death rates. These findings are consistent with the hypothesis that trauma centers are associated with a decrease in trauma death rates.

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