Does Transfer to Tertiary Trauma Centers Improve Survival?

A study published in November in Academic Emergency Medicine sought to evaluate the impact on survival among patients initially presented to non-tertiary trauma centers and subsequently transferred to tertiary trauma centers versus those who remained at non-tertiary trauma centers.¹ The retrospective cohort study included 6,229 trauma patients presenting to 104 non-tertiary centers in Oklahoma; 2,669 (43%) were transferred to tertiary trauma centers. Of those transferred, 1,422 patients, or 53%, were moved to a Level I trauma center.

“After adjusting for the propensity to be transferred, injury severity score, presence of severe head injury and age, transfer to a tertiary trauma center was associated with a significantly lower 30-day mortality compared to admission and treatment at a non-tertiary trauma center.” The investigators found that the survival benefit was similar for patients transferred to either a Level I trauma center and a Level II center.

“This study suggests a survival benefit among patients initially presenting to non-tertiary trauma centers who are subsequently transferred to tertiary trauma centers compared to those remaining in non-tertiary trauma centers, even after adjusting for variables affecting the likelihood of transfer. Although this survival benefit was larger for patients treated at a Level I trauma center, Level II trauma centers in a region with few tertiary trauma resources demonstrated a measurable benefit as well,” they state.

Reference

1. Garwe T, Cowan LD, Nease B, et al. Survival benefit of transfer to tertiary trauma centers for major trauma patients initially presenting to non-tertiary trauma centers. Acad Emerg Med. 2010(11);1223—1232.