Level I Trauma Centers Decrease Risk of Death, Disability Compared With Level II Centers, Study Finds

Patients with severe traumatic injuries are 20% more likely to die if they are taken to a Level II trauma center than if they are taken to a Level I trauma center, according to a study by researchers at the University of Southern California's Keck School of Medicine, the Los Angeles Times reports.

For the study, led by Demetrios Demetriades, head of the USC Medical Center's trauma unit, researchers examined the outcomes of about 12,000 severe trauma patients at 248 trauma centers nationwide and compared the outcomes of patients at Level I and Level II centers.

The American College of Surgeons defines Level I trauma centers as major regional academic centers that can perform surgeries 24 hours per day, have a surgical intensive unit and provide continuing research and training for surgical residents. Level II centers typically have fewer resources and are not required to have teaching and research programs.

The study found that 34% of trauma patients at Level II facilities were severely disabled at discharge, compared with 20% of patients discharged from Level I centers.

Demetriades said the study results suggest trauma patients should receive treatment at Level I facilities even if they must travel farther to reach them.

Some Los Angeles County officials said the study's results should not be applied locally without further research because requirements at the county's nine Level II trauma centers "are significantly more stringent that those at the national level," the Times reports.

Carol Meyer, director of the county's Emergency Medical Services Agency, said, "Our trauma surgeons and anesthesiologists have to be in the hospital 24 hours a day. In some Level II trauma centers (elsewhere in the nation), they don't" (Lin, Los Angeles Times, 10/7).