Author/Authors :
Lavigueur, Olivier Universit´e de Montr´eal - Montr´eal, Canada , Nemeth, Joe Department of Emergency Medicine - McGill University - Montr´eal, Canada , Razek, Tarek Department of Trauma - McGill University - Montr´eal, Canada , Maghraby, Nisreen Trauma and Disaster Medicine - Immam Abdulrhman Bin Faisal University - Dammam - Saudi Arabia
Abstract :
Background. To illustrate the impact of the implementation of a multidisciplinary TTL program in 2005 on the mortality of trauma patients in a level 1 trauma center as well as admission rates and length of stay. Methods. Retrospective observational study of all trauma patients included in the provincial trauma database at the Montreal General Hospital between 1998 and 2015. the primary
outcome studied was in-hospital mortality. the secondary outcomes studied were hospital and intensive care unit (ICU) rates of
admission and hospital and ICU length of stay. Results. 24,107 patients were included. We observed a statistically significant
reduction in mortality of 1.25% or a relative reduction of 16% (p value � 0.0058; rate ratio 0.844 (95% CI 0.747–0.952)). ICU
admissions were also significantly reduced where we observed a statistically significant absolute reduction of 4.46% or a relative
reduction of 14% (p value � 8.38 ×10−7
; rate ratio 0.859 (95% CI 0.808–0.912)). *e ICU length of stay was increased by 0.91 days
or 19.03% (p value � 0.016 (95% CI 0.167–1.655)). *ere was no observed change in overall length of stay (13.97 days pre-TTL and
12.91 post-TTL (p value � 0.13; estimate −1.053 (95% CI −2.424–0.318))). Conclusions. *is article suggests that multidisciplinary
TTL model may be beneficial in the care of trauma patients. Further subgroup analysis may help determine which patients could benefit more.
Keywords :
ICU length , Trauma , Tertiary Trauma Center , Multidisciplinary