The Editors have satisfied themselves that all authors have contributed significantly to this publication
A major trauma centre is a specialty hospital not a hospital of specialties†
Article first published online: 10 DEC 2009
Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
British Journal of Surgery
Volume 97, Issue 1, pages 109–117, January 2010
How to Cite
Davenport, R. A., Tai, N., West, A., Bouamra, O., Aylwin, C., Woodford, M., McGinley, A., Lecky, F., Walsh, M. S. and Brohi, K. (2010), A major trauma centre is a specialty hospital not a hospital of specialties. Br J Surg, 97: 109–117. doi: 10.1002/bjs.6806
- Issue published online: 10 DEC 2009
- Article first published online: 10 DEC 2009
- Manuscript Accepted: 20 JUL 2009
High estimates of preventable death rates have renewed the impetus for national regionalization of trauma care. Institution of a specialist multidisciplinary trauma service and performance improvement programme was hypothesized to have resulted in improved outcomes for severely injured patients.
This was a comparative analysis of data from the Royal London Hospital (RLH) trauma registry and Trauma Audit and Research Network (England and Wales), 2000–2005. Preventable mortality was evaluated by prospective analysis of the RLH performance improvement programme.
Mortality from critical injury at the RLH was 48 per cent lower in 2005 than 2000 (17·9 versus 34·2 per cent; P = 0·001). Overall mortality rates were unchanged for acute hospitals (4·3 versus 4·4 per cent) and other multispecialty hospitals (8·7 versus 7·3 per cent). Secondary transfer mortality in critically injured patients was 53 per cent lower in the regional network than the national average (5·2 versus 11·0 per cent; P = 0·001). Preventable death rates fell from 9 to 2 per cent (P = 0·040) and significant gains were made in critical care and ward bed utilization.
Institution of a specialist trauma service and performance improvement programme was associated with significant improvements in outcomes that exceeded national variations. Copyright © 2010 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.