The adjusted rate of death at trauma centers in the Portland, Ore., area dropped by one-third after a regional trauma system was established.
An article published in the June 22-29 Journal of the American Medical Association examined two key measures of a trauma system's success: whether more severely injured patients actually end up at trauma centers, and if more live.
Retrospective studies of injured patients admitted to hospitals that aren't designated trauma centers have said that optimal care might have prevented 20% to 40% of fatalities.
The Oregon Legislature mandated a trauma system in 1986. Under the program, emergency medical technicians evaluate patients at the scene of injury and decide who should be taken to designated trauma centers.
Four years after the Oregon system began, the adjusted rate of trauma deaths at the region's two designated trauma centers dropped, although overall death rates in the region didn't change, said researchers at the Oregon Health Sciences center in Portland.
The number of patients treated at trauma centers rose to 1,530 in 1990 and 1991, from 580 in 1984 and 1985. In the final two years examined, 77% of severely injured patients were admitted to one of two centers. The majority of trauma patients who died were men with serious-often multiple-injuries.