Systematic review of published evidence regarding trauma system effectiveness

N. C. Mann, Richard Mullins, E. J. MacKenzie, G. J. Jurkovich, C. N. Mock

    Research output: Contribution to journalArticle

    231 Citations (Scopus)

    Abstract

    Objective: Provide a systematic review of the published literature assessing the affect of trauma center/system implementation on patient outcomes. Data Sources: A bibliographic search of MEDLINE (1966 May of 1998), HealthSTAR (1995 - May of 1998), and CINAHL (1982 - May of 1998). Additional manuscripts were identified in the references of reviewed manuscripts. Literature was limited to English language reports on trauma systems in the United States and Canada. Study Selection: Initial inclusion criteria were based on methodologic criteria (i.e., a comparative [controlled] study). Authors independently assessed the strength of evidence demonstrated by each article. Data Extraction: Included articles were classified into three groups based on study design: panel review studies, trauma registry comparison studies, and population-based studies. Key demographic, sampling frame, study design, and outcome variables were tabulated for each included study. Potential sources of bias were also identified and tabled. Data Synthesis: A total of 12, 11, and 17 studies were incorporated into individual evidence tables for panel review, registry comparison, and population-based studies, respectively. Included studies rely on weak evidence (Class III) to assess the impact of trauma systems on patient care and outcome. Conclusions: To date, studies assessing trauma system efficacy rely on hospital deaths as the primary indicator of effectiveness. Future research should use more sophisticated study designs (Class II) and expand available outcome measures to assess the entire continuum of care, including prehospital, rehabilitation outcomes, and long-term quality of life.

    Original languageEnglish (US)
    JournalJournal of Trauma - Injury, Infection and Critical Care
    Volume47
    Issue number3 SUPPL.
    StatePublished - 1999

    Fingerprint

    Manuscripts
    Wounds and Injuries
    Registries
    Sampling Studies
    Continuity of Patient Care
    Trauma Centers
    Information Storage and Retrieval
    MEDLINE
    Population
    Canada
    Patient Care
    Language
    Quality of Life
    Demography
    Outcome Assessment (Health Care)

    Keywords

    • Evidence report
    • Mortality
    • Trauma systems

    ASJC Scopus subject areas

    • Surgery

    Cite this

    Systematic review of published evidence regarding trauma system effectiveness. / Mann, N. C.; Mullins, Richard; MacKenzie, E. J.; Jurkovich, G. J.; Mock, C. N.

    In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 47, No. 3 SUPPL., 1999.

    Research output: Contribution to journalArticle

    Mann, N. C. ; Mullins, Richard ; MacKenzie, E. J. ; Jurkovich, G. J. ; Mock, C. N. / Systematic review of published evidence regarding trauma system effectiveness. In: Journal of Trauma - Injury, Infection and Critical Care. 1999 ; Vol. 47, No. 3 SUPPL.
    @article{57dcca6dc092464081dcc52d6c1dfea2,
    title = "Systematic review of published evidence regarding trauma system effectiveness",
    abstract = "Objective: Provide a systematic review of the published literature assessing the affect of trauma center/system implementation on patient outcomes. Data Sources: A bibliographic search of MEDLINE (1966 May of 1998), HealthSTAR (1995 - May of 1998), and CINAHL (1982 - May of 1998). Additional manuscripts were identified in the references of reviewed manuscripts. Literature was limited to English language reports on trauma systems in the United States and Canada. Study Selection: Initial inclusion criteria were based on methodologic criteria (i.e., a comparative [controlled] study). Authors independently assessed the strength of evidence demonstrated by each article. Data Extraction: Included articles were classified into three groups based on study design: panel review studies, trauma registry comparison studies, and population-based studies. Key demographic, sampling frame, study design, and outcome variables were tabulated for each included study. Potential sources of bias were also identified and tabled. Data Synthesis: A total of 12, 11, and 17 studies were incorporated into individual evidence tables for panel review, registry comparison, and population-based studies, respectively. Included studies rely on weak evidence (Class III) to assess the impact of trauma systems on patient care and outcome. Conclusions: To date, studies assessing trauma system efficacy rely on hospital deaths as the primary indicator of effectiveness. Future research should use more sophisticated study designs (Class II) and expand available outcome measures to assess the entire continuum of care, including prehospital, rehabilitation outcomes, and long-term quality of life.",
    keywords = "Evidence report, Mortality, Trauma systems",
    author = "Mann, {N. C.} and Richard Mullins and MacKenzie, {E. J.} and Jurkovich, {G. J.} and Mock, {C. N.}",
    year = "1999",
    language = "English (US)",
    volume = "47",
    journal = "Journal of Trauma and Acute Care Surgery",
    issn = "2163-0755",
    publisher = "Lippincott Williams and Wilkins",
    number = "3 SUPPL.",

    }

    TY - JOUR

    T1 - Systematic review of published evidence regarding trauma system effectiveness

    AU - Mann, N. C.

    AU - Mullins, Richard

    AU - MacKenzie, E. J.

    AU - Jurkovich, G. J.

    AU - Mock, C. N.

    PY - 1999

    Y1 - 1999

    N2 - Objective: Provide a systematic review of the published literature assessing the affect of trauma center/system implementation on patient outcomes. Data Sources: A bibliographic search of MEDLINE (1966 May of 1998), HealthSTAR (1995 - May of 1998), and CINAHL (1982 - May of 1998). Additional manuscripts were identified in the references of reviewed manuscripts. Literature was limited to English language reports on trauma systems in the United States and Canada. Study Selection: Initial inclusion criteria were based on methodologic criteria (i.e., a comparative [controlled] study). Authors independently assessed the strength of evidence demonstrated by each article. Data Extraction: Included articles were classified into three groups based on study design: panel review studies, trauma registry comparison studies, and population-based studies. Key demographic, sampling frame, study design, and outcome variables were tabulated for each included study. Potential sources of bias were also identified and tabled. Data Synthesis: A total of 12, 11, and 17 studies were incorporated into individual evidence tables for panel review, registry comparison, and population-based studies, respectively. Included studies rely on weak evidence (Class III) to assess the impact of trauma systems on patient care and outcome. Conclusions: To date, studies assessing trauma system efficacy rely on hospital deaths as the primary indicator of effectiveness. Future research should use more sophisticated study designs (Class II) and expand available outcome measures to assess the entire continuum of care, including prehospital, rehabilitation outcomes, and long-term quality of life.

    AB - Objective: Provide a systematic review of the published literature assessing the affect of trauma center/system implementation on patient outcomes. Data Sources: A bibliographic search of MEDLINE (1966 May of 1998), HealthSTAR (1995 - May of 1998), and CINAHL (1982 - May of 1998). Additional manuscripts were identified in the references of reviewed manuscripts. Literature was limited to English language reports on trauma systems in the United States and Canada. Study Selection: Initial inclusion criteria were based on methodologic criteria (i.e., a comparative [controlled] study). Authors independently assessed the strength of evidence demonstrated by each article. Data Extraction: Included articles were classified into three groups based on study design: panel review studies, trauma registry comparison studies, and population-based studies. Key demographic, sampling frame, study design, and outcome variables were tabulated for each included study. Potential sources of bias were also identified and tabled. Data Synthesis: A total of 12, 11, and 17 studies were incorporated into individual evidence tables for panel review, registry comparison, and population-based studies, respectively. Included studies rely on weak evidence (Class III) to assess the impact of trauma systems on patient care and outcome. Conclusions: To date, studies assessing trauma system efficacy rely on hospital deaths as the primary indicator of effectiveness. Future research should use more sophisticated study designs (Class II) and expand available outcome measures to assess the entire continuum of care, including prehospital, rehabilitation outcomes, and long-term quality of life.

    KW - Evidence report

    KW - Mortality

    KW - Trauma systems

    UR - http://www.scopus.com/inward/record.url?scp=0032829150&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=0032829150&partnerID=8YFLogxK

    M3 - Article

    VL - 47

    JO - Journal of Trauma and Acute Care Surgery

    JF - Journal of Trauma and Acute Care Surgery

    SN - 2163-0755

    IS - 3 SUPPL.

    ER -