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Analysis of outcomes from a Level 1 trauma care hospital before and after movement to an integrated trauma care center

Year: 2025

Type: article

Abstract: PURPOSE: Quality improvement in trauma care often focuses on clinical protocols and systems, with limited emphasis on trauma-specific infrastructure. This study evaluated the impact of trauma-specific infrastructural improvements on patient outcomes in a newly established quaternary care trauma center. METHODS: Data from a prospectively maintained trauma registry were retrospectively analyzed. Patients treated over 8 months at the old center (OC) were compared to those treated during an equivalent period at the new center (NC), which included trauma-specific infrastructure such as a dedicated trauma bay, CT scanner, operating rooms, intensive care unit, and ward. Outcome indicators included time to CT, emergency department (ED) disposition time, hospital stay, 24-h survival, and overall mortality. Regression analyses adjusted for clinical confounders were performed. RESULTS: A total of 3542 patients (OC: 1627, NC: 1915) were analyzed. The median time to CT (incident rate ratios (IRR): 0.615, 95% confidence intervals (CI): 0.494-0.767) and ED disposition time (IRR: 0.766, 95% CI: 0.641-0.914) were significantly shorter in NC, particularly for priority 1 patients. However, hospital stay was longer in the new center (IRR 1.395, 95% CI: 1.224-1.590). There was no significant difference in 24-h survival (odds ratio: 0.330, 95% CI: 0.092-1.180) or overall mortality (odds ratio: 0.328, 95% CI: 0.084-1.275. CONCLUSION: Trauma-specific infrastructure improves key operational metrics like time to CT and ED disposition without significant survival benefits. These findings suggest that infrastructure, while beneficial, should complement robust clinical systems and protocols for improved trauma care quality.

Source: Chinese Journal of Traumatology

DOI: 10.1016/j.cjtee.2025.04.005

Authors: Haarini Sundar, Carlton Rowlands, Vijayan Purushothaman, Vignesh Kumar, Srujan Lam Sharma, Shona Rachel Mathuram, Sukria Nayak, Joses Dany James

Institutions: Christian Medical College, Vellore, James Cook University Hospital, SRM Medical College Hospital and Research Centre, Pondicherry Institute of Medical Sciences

Language: English

Topic: Trauma and Emergency Care Studies

Subfield: Emergency Medicine

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Industry, innovation and infrastructure

Open Access status: diamond

OpenAlex ID: W4416868012

FWCI:

Cites: 16

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