Population-Based Research Assessing the Effectiveness of Trauma Systems

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Abstract
To review published evidence regarding the effectiveness of trauma systems by using population-based data. A systematic review of peer-reviewed literature assessing the influence of trauma system implementation on the outcome of all injured patients. Literature available in MEDLINE, HealthSTAR, and CINHAL was reviewed for studies that use population-based data to assess the benefit of trauma system development. Studies were included that assessed trauma systems in North America and used a comparison or control group in the analysis. Published evidence, reported for eight of the nine trauma systems evaluated, demonstrates improved outcomes, principally measured as hospital survival. Improvement occurred after the trauma system or some component of a trauma system (e.g., sophisticated prehospital care) was established. Population-based evidence supports a 15 to 20% improved survival rate among seriously injured patients with trauma system implementation. Future study is required to determine whether trauma systems improve the outcome of all injured patients, not just high-risk subsets of the population.

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