Annals of Emergency Medicine
Volume 18, Issue 11 , Pages 1141-1145, November 1989

The impact of a regionalized trauma system on trauma care in San Diego County

    MD, FACP
  • David A Guss

      Affiliations

    • Department of Emergency Medical Services, University of California, San Diego, Medical Center, USA
    • Corresponding Author InformationAddress for reprints: David A Guss, MD, Emergency Medical Services, UCSD Medical Center, 225 Dickinson Street, H-665-A, San Diego, California 92103-1990.
    • ,
  • F Thomas Meyer

      Affiliations

    • University of California, San Diego School of Medicine, USA
    • , MD, FACP
  • Tom S Neuman

      Affiliations

    • Department of Emergency Medical Services, University of California, San Diego, Medical Center, USA
    • , MD
  • William G Baxt

      Affiliations

    • Department of Emergency Medical Services, University of California, San Diego, Medical Center, USA
    • , MD, FACEP
  • James V Dunford Jr

      Affiliations

    • Department of Emergency Medical Services, University of California, San Diego, Medical Center, USA
    • , MD
  • Lee D Griffith

      Affiliations

    • Division of Cardiothoracic Surgery, University of California, San Diego, California, USA
    • , MD
  • Steven L Guber

      Affiliations

    • Tri-City Surgery, Inc, Medical Group, Oceanside, California, USA

Received 10 March 1989; received in revised form 19 June 1989; accepted 6 July 1989.

A review of autopsy reports on traumatic deaths in 1986 was conducted to determine the impact on trauma mortality of the regionalized trauma system instituted in San Diego County in 1984. Determination of preventable death was made by a panel of experts and compared with an identical review of traumatic deaths in 1979, five years before the institution of regionalized trauma care. Of 211 traumatic deaths reviewed from 1986, two (1%) were classified as preventable, compared with 20 of 177 (11.4%) deaths in 1979 (P < .001). A breakdown of trauma deaths into central nervous system and noncentral nervous system categories revealed the overall decline was in large part a consequence of the decline in non-central nervous system deaths from 16 of 83 in 1979 to one of 62 in 1986 (P < .005). The decrease in central nervous system-related preventable deaths from four of 94 in 1979 to one of 149 in 1986 (P < .10) was not statistically significant. Although it is likely the trauma system introduced in 1984 contributed to the decline in preventable death, it is not possible to isolate this variable from other changes that occurred during the interval between studies. A review of trauma deaths over the same time interval in a community with similar demographics but without a trauma system might help determine the relative contribution of the trauma system.

trauma systems

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 Presented at the Society for Academic Emergency Medicine Annual Meeting in San Diego, May 1989.

PII: S0196-0644(89)80048-4

Annals of Emergency Medicine
Volume 18, Issue 11 , Pages 1141-1145, November 1989

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