AN EVALUATION OF PATIENT OUTCOMES COMPARING TRAUMA TEAM ACTIVATED VERSUS TRAUMA TEAM NOT ACTIVATED USING TRISS ANALYSIS

Objective: The purpose of this study was to compare the outcomes of tr auma patients with an Injury Severity Score (ISS) > 12 who had the tra uma team involved (TTA) in their resuscitative care to those that did not (TTNA). Setting: Level I regional trauma center teaching hospital with university affiliation, Methods: All trauma patients admitted bet ween July 1, 1991 and August 31, 1994 with an ISS > 12 were identified through the trauma registry. Burn patients, those who suffered their injury > 24 hours before admission, and deaths in the emergency room w ere excluded from analysis. The TRISS methodology, which offers a stan dard approval for evaluating outcomes for different populations of tra uma patients, was used to determine whether there was a difference in outcomes between the two groups, To include patients who arrived at th e trauma center intubated. a Trauma and Injury Severity Score (TRISS)- like analysis was also conducted on this patient population. Main Resu lts: A total of 640 patients were identified; 417 (65.2%) in the TTA g roup and 223 (34.8%) in the TTNA group. ii total of 448 (70%) were eli gible for TRISS analysis and 574 (89.7%) were eligible for TRISS-like analysis, Using the TRISS analysis, the TTA group had a Z statistic of 3.36 yielding a W score of 4.27. This compared to the TTNA group whos e Z statistic was 0.30. Using the TRISS-like logistic regression equat ion, the TTA group had a Z statistic of 6.50, yielding a W score of 8. 60 compared with the TTNA group whose Z statistic was 0.88. After cont rolling for differences in the demographics of the two groups. the TTA still had consistently higher Z scores, Conclusion: In a Level I trau ma center, the outcomes of trauma patients with an LSS > 12 are statis tically significantly better if the trauma team is activated than if t he patients are managed an an individual service-by-service basis.