Trauma Center Care Associated With Improved Head Injury Outcomes

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Initial presentation to a trauma center was associated with no significant difference in overall mortality, but with a higher rate of discharge home.
Initial presentation to a trauma center was associated with no significant difference in overall mortality, but with a higher rate of discharge home.

HealthDay News — Patients with isolated, severe head injury have better outcomes if they are initially treated in designated trauma centers, according to a study published online in the Journal of the American College of Surgeons.

Elinore J. Kaufman, MD, from New York-Presbyterian Weill Cornell Medicine in New York City, and colleagues used the State Emergency Department and Inpatient Databases for 6 states (2011 to 2012) to retrospectively assess patients with severe, isolated head injury. Comparisons were made between in-hospital mortality and discharge status for all adults initially presented to either a trauma center or a neurosurgery-capable non-trauma center.

The researchers found that 62,198 patients presented with severe, isolated head injury, with 44.2% presenting to non-trauma centers and 55.8% presenting to trauma centers. Overall, initial presentation to a trauma center was associated with no significant difference in overall mortality, but with a 5.8% higher rate of discharge home. However, for patients aged ≥65 years, initial presentation to a trauma center was associated with a 3.4% reduction in mortality.

"Patients with isolated, severe head injury have better outcomes if initially treated in designated trauma centers," the authors write. "As 40% of such patients were triaged to non-trauma centers, there are major opportunities for improving outcomes."

Reference

Kaufman EJ, Ertfaie A, Small DS, Holena DN, Delgado MK. Comparative effectiveness of initial treatment at trauma center vs neurosurgery-capable non-trauma center for severe, isolated head injury [published online March 1, 2018]. J Am Coll Surg. doi:10.1016/j.jamcollsurg.2018.01.055

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