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BACKGROUND While the benefit of admission to trauma centers compared to non-trauma centers is well-documented and differences in outcomes between Level-I and Level-II trauma centers are well-studied, data on the differences in outcomes between Level-II trauma centers (L2TCs) and Level-III trauma centers (L3TCs) are scarce. OBJECTIVE We sought to compare mortality risk between patients admitted to L2TCs and L3TCs, hypothesizing no difference in mortality risk for patients treated at L3TCs compared to L2TCs. METHODS A retrospective analysis of the 2016 Trauma Quality Improvement Program (TQIP) database was performed. Patients aged 18+ years were divided into 2 groups, those treated at American College of Surgeons (ACS) verified L2TCs and L3TCs. RESULTS From 74,486 patients included in this study, 74,187 (99.6%) were treated at L2TCs and 299 (.4%) at L3TCs. Both groups had similar median injury severity scores (ISSs) (10 vs 10, P < .001); however, L2TCs had a higher mean ISS (14.6 vs 11.9). There was a higher mortality rate for L2TC patients (6.0% vs 1.7%, P = .002) but no difference in associated risk of mortality between the 2 groups (OR .46, CI .14-1.50, P = .199) after adjusting predictors of mortality. L2TC patients had a longer median length of stay (5.0 vs 3.5 days, P < .001). There was no difference in other outcomes including myocardial infarction (MI) and cerebrovascular accident (CVA) (P > .05). CONCLUSIONS Patients treated at L2TCs had a longer LOS compared to L3TCs. However, after controlling for covariates, there was no difference in associated mortality risk between L2TC and L3TC patients.
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Areg Grigorian, and
Ahmed Farhat, and
Theresa L Chin, and
Megan Donnelly, and
Matthew Dolich, and
Catherine M Kuza, and
Michael Lekawa, and
Jeffry Nahmias
April 2024,
The American surgeon,
Ali Farhat, and
Areg Grigorian, and
Ahmed Farhat, and
Theresa L Chin, and
Megan Donnelly, and
Matthew Dolich, and
Catherine M Kuza, and
Michael Lekawa, and
Jeffry Nahmias
February 2023,
The journal of trauma and acute care surgery,
Ali Farhat, and
Areg Grigorian, and
Ahmed Farhat, and
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Megan Donnelly, and
Matthew Dolich, and
Catherine M Kuza, and
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Jeffry Nahmias
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American journal of surgery,
Ali Farhat, and
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March 2015,
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Michael Lekawa, and
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Ali Farhat, and
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