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Good Trauma Program Boosts Patient Survival

FRIDAY, Aug. 21 -- A surgeon's experience doesn't affect trauma patients' chances of survival if they're treated within a structured trauma program, according to a new report.

In the study, researchers examined deaths among almost 14,000 trauma patients treated at the Johns Hopkins Hospital in Baltimore over 10 years (1994-2004). This period included years before and after the hospital hired a highly experienced trauma surgeon to serve as trauma program director.

During the first 3.5 years, 4,499 patients were treated by novice surgeons. During the remaining years, novice surgeons treated 5,783 patients while the experienced surgeon treated 3,612 patients. There were no differences in death rates between patients treated by novice surgeons during the latter years and patients treated by the experienced surgeon, the researchers found.

Patients treated by novice surgeons were 44 percent less likely to die after the hiring of the experienced surgeon as trauma program director.

"Together, these data support the belief that in a structured trauma program, surgeons with vastly different levels of training can safely provide care and obtain equivalent outcomes," the Johns Hopkins University School of Medicine researchers concluded.

"System effects outweigh any potential benefits of individual surgeon experience in the care of trauma patients. The implementation of an organized trauma program with evidence-based protocols and senior surgical guidance may have a greater effect on mortality than individual surgeon experience alone."

The study appears in the August issue of the Archives of Surgery.

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Posted: August 2009