Because trauma admission and hospitalization patterns have profound effects
on the organization and utilization of urban trauma-care systems, the obje
ctive of this study was to identify and analyze these patterns. As an examp
le, admissions to an urban Level I trauma center were reviewed. Retrospecti
ve review of all 2029 trauma admissions to a Level I trauma center was cond
ucted from 1993 to 1996. The result was that most trauma patients were youn
g (40% <30 years of age) and male (74%). Mechanisms of injury were motor ve
hicle accident (36%), fall (27%), gunshot (17%), stab (7%), assault (6%), a
nd swimming or diving accident (3%). Half of the patients were directly adm
itted from the scene. Injury Severity Score, length of stay, and mortality
were 14.1 +/- 0.3, 10.5 +/- 0.3 days, and 5.1%, respectively. Admissions te
nded to occur more frequently between 4:00 PM and midnight (46%), between F
riday and Sunday (52%), and between July and October (41%). The following p
atterns were identified: admissions per year decreased (-21%) because of re
duced penetrating trauma (-43%, P <.01); pediatric patients (<15 years) had
similar incidence of penetrating trauma as adults (ages 15-45). Length of
stay for all mechanisms of injury was not statistically different; most mor
talities occurred within the first day (33%, P <.01) or after 6 days (36%,
P <.01); early mortality was mainly due to penetrating injury (74%, P <.01)
, whereas late mortality was related to blunt trauma (92%, P <.01). The con
clusion was that admission and demographic patterns were identified, which
may be useful in the utilization, modification, and future design of trauma
systems.