Relationship Between Trauma Center Volume and Outcomes

Abstract

The premise underlying regionalization of trauma care is that optimal outcomes can be achieved at greatest efficiency if care is restricted to relatively few dedicated trauma centers. Limitation of the number of trauma centers based on community need has been proposed as a critical component of regional trauma systems and, in a recent evaluation of systems across the country, one of their most frequent deficiencies.^1,2 Implicit in this premise is that higher patient volumes will lead to greater experience and that this experience translates into better outcomes. This relationship appears to hold true for other areas of surgical care, including major oncologic, cardiac, vascular, and neurosurgical procedures.^3-7 In contrast, no such relationship is evident when less complex procedures like cholecystectomy or operative management of hip fractures are considered,⁸ suggesting that the association between volume and outcomes is dependent on the complexity of care and the potential for adverse outcomes.