A benchmarking study of two trauma centres highlighting limitations when standardising mortality for comorbidity

World Journal of Emergency Surgery : WJES
Henry R BuddPeter Danne

Abstract

A continuous process of trauma centre evaluation is essential to ensure the development and progression of trauma care at regional, national and international levels. Evaluation may be by comparison between pooled datasets or by direct benchmarking between centres. This study attempts to benchmark mortality at two trauma centres standardising this for multiple case-mix factors, which includes the prevalence of individual background pre-existing diseases within the study population. Trauma patients with an Injury Severity Score (ISS) >15 admitted to the two centres in 2001 and 2002 were included in the study with the exception of those who died in the emergency department. Patient characteristics were analysed in terms of 18 case-mix factors including Glasgow Coma Scale on arrival, Injury Severity Score and the presence or absence of 9 co-morbidity types, and patient outcome was compared based on in-hospital mortality before and after standardisation. Crude mortality was greater at UHNS (18.2 vs 14.5%) with a non-significant odds ratio of 1.31 prior to adjusting for case-mix (P = 0.171). Adjustment for case mix using logistic regression analysis altered the odds ratio to 1.64, which was not significant (P = 0.069). This study di...Continue Reading

References

Apr 11, 1990·JAMA : the Journal of the American Medical Association·J A MorrisS L Edelstein
Jun 24, 2004·The Journal of Trauma·Gerald McGwinLoring W Rue

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Citations

Jul 2, 2014·British Journal of Anaesthesia·P OakleyG O Rhys Thomas
Aug 21, 2009·World Journal of Surgery·Ida Füglistaler-MontaliThomas Gross
Jan 16, 2016·SAGE Open Medicine·Frédérique ThononMahasti Saghatchian
Jan 25, 2014·The Journal of Trauma and Acute Care Surgery·Teegwendé Valérie PorgoJean Lapointe

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