Objective: By using mandatory discharge data from a state agency, the recor
ds of 116,687 patients hospitalized for treatment of injury were evaluated
to develop an epidemiologic and demographic profile of this population and
to compare outcomes of patients treated in state-designated trauma centers
(TC) with those treated in nontrauma centers (NTC).
Methods: Injury severity was calculated by using the International Classifi
cation Injury Severity Score methodology to compute individual diagnosis su
rvival risk ratios from 698,187 reported diagnoses, and then by using these
survival risk ratios to determine probability of survival for every patien
t. The population was then categorized by age, injury type, treatment facil
ity designation, injury severity as indicated by probability of survival, a
nd discharge disposition. Incidence of potentially preventable death was co
mpared between TC and NTC, as was the effect on outcome of noninjury comorb
idity.
Results: The average age of this population was 58 +/- 26 years with signif
icant skew toward the elderly in NTC (mean age, 62 +/- 26 years). The most
commonly encountered injuries likewise reflected the elderly nature of this
population. Although 71.3% received care in NTC, the majority of severely
injured were treated in TC, Potentially preventable mortality (>0.5) was si
gnificantly lower in TC. The effect of noninjury comorbidity on outcome was
better managed by TC, both in terms of decreased mortality and in proporti
on of patients discharged home.
Conclusion: These data demonstrate the unique characteristics of injury vic
tims treated in the state of Florida and indicate that the developing traum
a system is demonstrating productivity in terms of avoidance of preventable
death, efficient management of noninjury comorbid problems, and more compl
ete recovery as indicated by proportion of patients discharged to home.