Vaidehi Agrawal
Paul J. Deramo
Emily Lowrance
Chanhee Jo Chae
Joseph Darryl Amos

Background: Two systems exist for evaluating the abilities of trauma centers: the American College of Surgeons’ (ACS) verification and the State’s designation. Given criteria variations between the two systems, we studied clinical outcome variations of the same. Methods: The National Trauma Databank was queried from ۲۰۰۲ - ۲۰۰۹, ۲۰۱۳ & ۲۰۱۴ for all patients admitted to a State designated (SI) or ACS verified (AI) trauma facility. Centers that were exclusively state or ACS designated were used for analysis. Patient demographics, facility information and physiological variables were obtained. Outcome variables included length of stay, no of patients with complications and mortality. Multivariate logistic or linear regression analyses were employed for assessing outcome variations. Results: Of the ۱۲,۵۸۱,۳۷۵ trauma admissions, ۱,۵۰۴,۸۴۸ (۱۲%) met the inclusion criteria with ۱۵ AI and ۹۴ SI exclusive facilities identified. Patient demographics were ۶۶% male, ۶۲ - ۶۳% white and ۸۱% blunt injury. Higher length of stay, mortality, and complications were noted in SI vs. AI centers. Conclusions: Our results indicate ACS verified level I trauma centers have better clinical outcomes than State designated level I trauma centers. This study warrants future prospective studies to determine the impact of level of designation on clinical outcomes.

Quality of health care, Outcome Assessment (Health Care), Public Health Systems Research