In June 1990 the Ministry of Health designated eleven hospitals throughout Canada to be lead hospitals in trauma care. An integral part of a trauma system is the evaluation of care, in particular, outcome of the trauma patients. The TRISS (trauma score, injury severity score) methodology, which offers a standard approach for evaluating outcomes for different populations of trauma patients, was used to determine if there was an improvement in outcome following the designation of trauma centers of patients involved in motor vehicle crashes with an Injury Severity Score (ISS). The Revised Trauma Score (RTS), ISS, age and outcome were calculated or abstracted from the hospital chart of each patient at the trauma chart of each patient at the trauma centre. The study demonstrates and quantifies the improvements in patient outcomes associated with trauma centre designation. It also identifies a limitation of TRISS analysis and a method of eliminating the bias in trauma centre populations that are largely referred than direct off-the-street.
Abstract