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Are Trauma Team Activations Essential and Cost Effective for Rollover Crashes?
Abstract:
Background: Motor vehicle crashes (MVCs) are the leading cause
of death for ages 2-34 years. Rollover (RO) is defined as any
vehicle rotation of ≥90° about any longitudinal or lateral axis
occurring. The purpose of this study was to determine the cost
effectiveness of RO mechanism as the sole triage criteria.
Methods: Detailed patient injury, demographics, costs and crash
information were obtained on patients ≻16 years and seen at an ACS
COT-verified level I trauma center from 2007-2008. Analysis was
performed using SPSS v 17.
Results: 257 RO crash occupants were treated at this study
center. The frequency of AIS ≤2 in these RO occupants was 74%. 62%
(133/214) of patients triaged as partial TTA (PTTA) were discharged
from the emergency department (ED), whereas all full TTA (FTTA)
patients were admitted. 60% of all RO patients were reported to
have utilized seat belts. Seat belt use decreased the risk of
injury by four-fold (95% CI, 2.14-8.01). No other patient or crash
characteristics contributed to this excess triage rate. Based on an
average cost of $6,000/TTA and our excess ED discharge rate
exceeding the accepted national average rate of 37%, this trauma
center could save $498,000/year. Applying the same cost analysis to
the NASS database could save $190 million annually to the trauma
systems nationally.
Conclusion: Consideration of physiometric data, and seat belt
use in the triage of non-critically injured RO occupants could
potentially save this trauma center up to $2.5 million over a
five-year period and approximately $0.95 billion dollars for the
trauma systems nationwide over the same period.