Oct. 22, 2008 While the 2005 closure of King-Drew Medical Center's Level 1 trauma unit in Los Angeles County caused a 54 percent increase in trauma patients at nearby Harbor-UCLA Medical Center, the deaths among those patients actually declined, according to a new study published in The American Surgeon.
A team of researchers at Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed) examined 14,996 Harbor-UCLA Medical Center patient records before and after King-Drew Medical Center's closure because of speculation that longer transport times and greater patient volumes would lead to more deaths among trauma patients. Harbor-UCLA Medical Center is the closest Level 1 trauma center to King-Drew Medical Center and was expected to experience the greatest increase in trauma patients after King-Drew Medical Center's trauma unit shut down in 2005.
The LA BioMed study found the number of trauma patients at Harbor-UCLA Medical Center rose from a median of 123 a month to 190 a month after the closure. It also found the time to transport trauma patients to Harbor-UCLA Medical Center increased by about one minute, from a median of 12 minutes to 13 minutes. The severity of injuries among the hospital's trauma patients also rose after King-Drew's closure.
Despite these increases, the study found the mortality rates among all trauma patients at Harbor-UCLA Medical Center – when adjusted for the severity of the injuries – improved after King-Drew Medical Center shut down its trauma unit. Researchers said the increase in experience in treating trauma patients may be the reason for the improved outcomes for trauma patients at Harbor-UCLA Medical Center.
"Prior studies have found mortality rates are lower in high-volume trauma centers. This is likely due to the fact that surgeons and other health professionals treating these patients gain greater experience in dealing with a wider variety of injuries," said Christian de Virgilio, a LA BioMed researcher who was the corresponding author of the study. "Further studies will be needed to determine if there is a tipping point, where the trauma patient volume becomes so great that it actually causes mortality rates to rise."
Trauma is the leading cause of death for people between ages 1 and 38, and the third leading cause of death among all ages. Level 1 trauma centers provide the highest level of surgical care for trauma patients. While demand for emergency and trauma care is on the rise, the number of Level 1 trauma centers in Los Angeles County has declined from 10 in 1986 to just four today.
"Even though the study shows that we were effectively able to absorb the increased trauma volume associated with the closure of King-Drew's trauma center, we recognize that South Los Angeles would be optimally served by having its own local trauma center," Dr. de Virgilio said. "King-Drew Medical Center serves a very important function in the community because it provided much more than trauma services."
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The above story is based on materials provided by Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center (LA BioMed), via EurekAlert!, a service of AAAS.
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