Fb. Rogers et al., IN-HOUSE BOARD-CERTIFIED SURGEONS IMPROVE OUTCOME FOR SEVERELY INJURED PATIENTS - A COMPARISON OF 2 UNIVERSITY CENTERS, The journal of trauma, injury, infection, and critical care, 34(6), 1993, pp. 871-877
The benefit derived from in-house board-certified attending surgeons (
IHBCS) staffing trauma centers has recently been questioned. We compar
ed the outcomes and provider-related complications of patients with se
vere injuries who were treated at two university trauma centers, one w
ith IHBCS, and one with PGY-4 or PGY-5 residents in house (RIH). The R
IH center had a significantly longer resuscitation time (160 vs. 58.8
minutes; p < 0.01). Except in cases of vascular injury, the odds ratio
of dying at the RIH institution was significantly greater in all grou
ps when the variables of transport time, Revised Trauma Score, and ISS
were controlled. Errors in judgment were significantly more likely to
have been made at the RIH institution in all groups. It is concluded
that the management and ultimate outcome are significantly improved wh
en IHBCS are involved with the resuscitation and early care of specifi
c cohorts of severely injured patients.