Early experience of a regional trauma center in Gangwon province: First step toward organizing a regional trauma system

• Published in: Hong Kong journal of emergency medicine 2020-07, Vol.27 (4), p.202-210
• Main Authors: Kim, Kwangmin, Shim, Hongjin, Jung, Pil Young, Kim, Seongyup, Bang, Hui-Jae, Kwon, Hye Youn, Choi, Young Un, Bae, Keum Seok, Jang, Ji Young
• Format: Article
• Language: English
• Subjects: Care; Emergency medicine; Hospital care; Hospital patients; Mortality; Patients; Practice; preventable death; Preventable deaths; Trauma; Trauma centers; trauma outcome; trauma team activation
• ISSN: 1024-9079; 2309-5407
• DOI: 10.1177/1024907919831157

Background: The Korean Ministry of Health and Welfare decided to establish a trauma medical service system to reduce preventable deaths. OO hospital in Gangwon Province was selected as a regional trauma center and was inaugurated in 2015. Objectives: This study examines the impact of this center, comparing mortality and other variables before and after inaugurating the center. Methods: Severely injured patients (injury severity score > 15) presenting to OO hospital between January 2014 and December 2016 were enrolled and categorized into two groups: before trauma center (n = 365) and after trauma center (n = 904). Patient characteristics, variables, and patient outcomes (including mortality rate) before and after the establishment of trauma centers were compared accordingly for both groups. Risk factors for in-hospital mortality were also identified. Results: Probability of survival using trauma and injury severity score (%) method was significantly lower in the after trauma center group (81.3 +- 26.1) than in the before trauma center group (84.7 +- 21.0) (p = 0.014). In-hospital mortality rates were similar in both groups (before vs after trauma center group: 13.2% vs 14.2%; p = 0.638). The Z and W statistics revealed higher scores in the after trauma center group than in the before trauma center group (Z statistic, 4.69 vs 1.37; W statistic, 4.52 vs 2.10); 2.42 more patients (per 100 patients) survived after trauma center establishment. Conclusion: Although the mortality rates of trauma patients remained unchanged after the trauma center establishment, the Z and W statistics revealed improvements in the quality of care.