Influence of a Statewide Trauma System on Location of Hospitalization and Outcome of Injured Patients

Richard J. Mullins, Judith Veum-Stone, Jerris R. Hedges, Melanie J. Zimmer-Gembeck, N. Clay Mann, Patricia A. Southard, Mark Helfand, John A. Gaines, Donald D. Trunkey

Research output: Contribution to journalArticlepeer-review

168 Scopus citations


Objective: Evaluate the influence of implementing the Oregon statewide trauma system on admission distribution and risk of death. Design: Retrospective pre- and posttrauma system analyses of hospital discharge data regarding injured patients with one or more of the following injuries: head, chest, spleen/liver, pelvic fracture, and femur/tibia fracture. Materials and Methods: Risk-adjusted odds ratio of admission to Level I or II (tertiary care) trauma centers, and odds ratio of death were determined using hospital discharge abstract data on 27,633 patients. Patients treated in 1985-1987, before trauma system establishment, were compared to patients treated in 1991-1993 after the trauma system was functioning. Measurements and Main Results: After trauma system implementation, the odds ratio of admission to Level I or II trauma centers increased (odds ratio 2.36, 95% confidence interval 2.24-2.49). In addition, the odds ratio of death for injured patients declined after trauma system establishment (odds ratio 0.82, confidence interval 0.73-0.92). Conclusions: The Oregon trauma system was successfully implemented with more patients with index injuries admitted to hospitals judged most capable of managing trauma patients. The Oregon trauma system also appears beneficial since trauma system establishment is associated with a statewide reduction in risk of death.

Original languageEnglish (US)
Pages (from-to)536-545
Number of pages10
JournalJournal of Trauma - Injury, Infection and Critical Care
Issue number4
StatePublished - Apr 1996


  • Head injury
  • Rural and urban
  • Trauma system-Oregon

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine


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