What question did this study set out to answer?

To evaluate the impact of reorganizing trauma care into regional networks with designated Major Trauma Centres on clinical processes and patient survival across England.

August 1, 2018EClinicalMedicineOpen Access

Changing the System - Major Trauma Patients and Their Outcomes in the NHS (England) 2008–17

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Authors

CMChristopher G. MoranNottingham University Hospitals NHS Trust FLFiona LeckyDepartment of Health and Social Care OBOmar BouamraUniversity of Manchester

Discussion

Member takes

Overview

Longitudinal cross-sectional study demonstrates improved risk-adjusted survival in severe trauma patients following regional system restructuring, indicating benefits of centralized trauma care.

Key Points

To evaluate the impact of reorganizing trauma care into regional networks with designated Major Trauma Centres on clinical processes and patient survival across England.
Conducted a longitudinal series of annual cross-sectional studies from April 2008 to March 2017 using national clinical audit data in England.
Analyzed N = 110,863 patients with an Injury Severity Score ≥ 9 admitted to 35 consistently submitting hospitals.
Assessed changes in care delivery and outcomes using case-mix risk-adjusted survival models and interrupted time series analysis around the April 2012 system reconfiguration.
Overall unadjusted mortality was 9.2% (10,247/110,863 deaths) among patients with an ISS ≥ 9, showing no change in raw mortality over time.
Case-mix adjusted odds of survival from severe injury increased by 19% (95% CI, 3%–36%) across the 9-year study period.
Interrupted time series analysis demonstrated a significant post-intervention slope increase after April 2012 (+0.08% excess survivors per quarter, p = 0.023).

Cite This Study

Moran et al. (2018) studied this question.

synapsesocial.com/papers/6a7144bf75498292b70abfbd https://doi.org/10.1016/j.eclinm.2018.07.001

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August 1, 2018EClinicalMedicineOpen Access

Changing the System - Major Trauma Patients and Their Outcomes in the NHS (England) 2008–17

View Full Paper

Ask AI

Bookmark

Authors

CMChristopher G. MoranNottingham University Hospitals NHS Trust FLFiona LeckyDepartment of Health and Social Care OBOmar BouamraUniversity of Manchester

Discussion

Member takes

Overview

Longitudinal cross-sectional study demonstrates improved risk-adjusted survival in severe trauma patients following regional system restructuring, indicating benefits of centralized trauma care.

Key Points

To evaluate the impact of reorganizing trauma care into regional networks with designated Major Trauma Centres on clinical processes and patient survival across England.
Conducted a longitudinal series of annual cross-sectional studies from April 2008 to March 2017 using national clinical audit data in England.
Analyzed N = 110,863 patients with an Injury Severity Score ≥ 9 admitted to 35 consistently submitting hospitals.
Assessed changes in care delivery and outcomes using case-mix risk-adjusted survival models and interrupted time series analysis around the April 2012 system reconfiguration.
Overall unadjusted mortality was 9.2% (10,247/110,863 deaths) among patients with an ISS ≥ 9, showing no change in raw mortality over time.
Case-mix adjusted odds of survival from severe injury increased by 19% (95% CI, 3%–36%) across the 9-year study period.
Interrupted time series analysis demonstrated a significant post-intervention slope increase after April 2012 (+0.08% excess survivors per quarter, p = 0.023).

Cite This Study

Moran et al. (2018) studied this question.

synapsesocial.com/papers/6a7144bf75498292b70abfbd https://doi.org/10.1016/j.eclinm.2018.07.001

Also Consider

Synapse has enriched one closely related paper. Consider it for comparative context:

1Transfusion of Plasma, Platelets, and Red Blood Cells in a 1:1:1 vs a 1:1:2 Ratio and Mortality in Patients With Severe Trauma2015 · 2,552 citations

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