Trauma Quality Indicators Linked to Clinical Outcomes

In-hospital mortality, major complications strongly linked with ACSCOT quality indicators

WEDNESDAY, Dec. 21 (HealthDay News) -- Several of the American College of Surgeons Committee on Trauma (ACSCOT) quality indicators have significant associations with in-hospital mortality and the composite outcome of death or major complications, according to a study published online Dec. 19 in the Archives of Surgery.

Laurent G. Glance, M.D., from the University of Rochester School of Medicine in New York, and colleagues examined the association between the ACSCOT quality indicators and outcomes. Data were collected from 210,942 patients admitted to trauma centers between 2000 and 2009. The association between ACSCOT quality indicators and in-hospital mortality and death or major complications was assessed using regression analyses.

The investigators found that increased in-hospital mortality or death or major complications were associated with seven of the ACSCOT quality indicators. A four-fold increase in mortality, and nearly three-fold increase in the risk of death or major complications, were seen for patients with a Glasgow Coma scale score less than 13 who did not receive a head computed tomography scan (adjusted odds ratio [aOR], 4.39 and 2.76, respectively). There was a nearly five-fold increase in mortality for those with gunshot wounds to the abdomen that were managed nonoperatively (aOR, 4.80). A strong association was seen for femoral fractures treated with non-fixation and mortality or death or major complications (aOR, 4.08 and 2.54, respectively).

"Several current ACSCOT quality indicators have a strong association with clinical outcomes," the authors write.

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