IMPACT OF TRAUMA ATTENDING SURGEON CASE VOLUME ON OUTCOME - IS MORE BETTER

Objective: To examine the relationship between annual trauma volume pe r surgeon and years of attending experience with outcome in a Level I trauma center with a large panel of trauma attending surgeons. Methods : The outcomes of trauma patients were examined in 1995 and 1996 in re lationship to surgeon annual trauma volume and years of experience. Ou tcome variables studied included overall mortality, mortality stratifi ed by Trauma and Injury Severity Score, mortality in patients with an Injury Severity Score greater than 15, and preventable or possibly pre ventable deaths. Morbidity outcomes examined were overall complication rate and length of stay per attending surgeon. Additionally, five dif ficult problems were evaluated for critical management decisions by th e attending surgeons, and these outcomes were correlated to annual vol ume and experience. Results: There was no difference in outcome in eit her morbidity or mortality that correlated with annual volume of patie nts treated or years of experience. Critical management errors occurre d sporadically and were not related to volume or experience. Conclusio ns: Outcome after trauma seemed to be related to severity of injury ra ther than annual volume of cases per surgeon. Although our results may not be applicable to other institutions, they should urge caution in adopting and promulgating volume requirements for individual attending surgeons in trauma centers.