Implementing acute care surgery at a level i trauma center: 1-year prospective evaluation of the impact of this shift on trauma volumes and outcomes

Bernardino C. Branco, Kenji Inaba, Lydia Lam, Agathoklis Konstantinidis, Andrew L. Tang, Peep Talving, Ali Salim, Demetrios Demetriades

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Background: The purpose of this study was to evaluate the impact of the transition to acute care surgery (ACS) on trauma volumes and outcomes. Methods: All admissions from 2 1-year periods from June 2008 to May 2010 (1 year before ACS and 1 year after ACS) to the LAC+USC Medical Center were prospectively collected. In anticipation of this change, trauma patient demographics, clinical data, and outcomes (trauma volume and preventable and potentially preventable deaths and complications) were prospectively collected. Results: Before ACS, there were 5,378 trauma admissions. After ACS, there were 5,726 (66.5%) trauma and 2,886 (33.5%) nontrauma admissions. There were no demographic or clinical differences between trauma patients in the 2 groups. There was no significant difference in overall mortality (3.8% before ACS vs 3.3% after ACS, P =.292). Similarly, there were no differences in the rates of preventable and potentially preventable deaths or complications observed (1.2% vs 1.0%, P =.374) during the study period. Conclusions: Despite a 60% increase in total patient volume and a 233% increase in operative volume over the study period, the addition of emergency surgery to a trauma service did not compromise trauma patient outcomes.

Original languageEnglish (US)
Pages (from-to)130-135
Number of pages6
JournalAmerican journal of surgery
Volume206
Issue number1
DOIs
StatePublished - Jul 1 2013

Keywords

  • Acute care surgery
  • Mortality
  • Outcomes
  • Preventable and potentially preventable deaths and complications
  • Trauma volume

ASJC Scopus subject areas

  • Surgery

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