Trauma Systems

Although trauma centers have been present in the United States since 1966, trauma systems are relatively new. In this issue ofThe Journal, Bazzoli et al1present an update on the progress of trauma system development in the United States. Their report represents an extension of a previous article by West et al.2In addition to reviewing the original eight trauma system criteria of West and colleagues, the current report expands on the original study and provides a more sophisticated analysis of trauma systems and their development. Bazzoli et al show that since the publication of the report by West et al the number of complete trauma systems in the United States has increased from a relatively abysmal two complete systems in 1987 to five complete systems in 1993. See also p 395. One of the reasons for writing this progress report is the contention by the authors