ArticleThe journal of trauma and acute care surgery2018
The epidemiology of emergency department thoracotomy in a statewide trauma system: Does center volume matter?
Article in The journal of trauma and acute care surgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Transport and destination hospital for patients with suspected multiple and/or severe injuries - a systematic review and clinical practice guideline update.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Pooled it
- Evaluation and Implication of Case Volume Variation in Level 1 and 2 Trauma Centers.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025Article
- Article
- Process times of severely injured patients in the emergency room are associated with patient volume: a registry-based analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Short-term outcome of isolated lateral malleolar fracture treatment is independent of hospital trauma volume or teaching status: a nationwide retrospective cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Structured and Systematic Team and Procedure Training in Severe Trauma: Going from 'Zero to Hero' for a Time-Critical, Low-Volume Emergency Procedure Over Three Time Periods.World journal of surgery · 2021Observational
- Practice, Practice, Practice! Effect of Resuscitative Endovascular Balloon Occlusion of the Aorta Volume on Outcomes: Data From the AAST AORTA Registry.The Journal of surgical research · 2020Article
- A National Study of Emergency Thoracotomy for Trauma.Journal of emergencies, trauma, and shockArticle
- HoloLensTherapeutic advances in urologyReview
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
backgroundThe relationship between high volume and improved outcomes has been described for a host of elective high-impact, low-frequency procedures, but there are little data to support such a relationship in high-impact low-frequency procedures in trauma. Using emergency department thoracotomy (EDT) as a model, we hypothesized that patients presenting to centers with higher institutional volumes of EDT would have improved survival referent to those presenting to lower volume institutions.
methodsWe queried the Pennsylvania Trauma Outcomes Study registry from 2007 to 2015 for all EDTs performed at Level I and II centers identified by ICD-9 procedure codes and a location stamp indicating the emergency department. We examined patient-level risk factors for survival in univariate regression and multivariable regression models. Centers were divided into tertiles of mean annual EDT volume, and the association between mean annual EDT volume and patient survival was examined using logistic regression after controlling for patient factors.
results1,399 EDTs were performed at 28 centers. Overall survival was 6.8%. After controlling for patient age, mechanism of injury, signs of life, and injury severity, patients presenting to centers in the highest tertile of volume had significantly higher odds of survival compared with patients presenting to centers in the lowest tertile of volume (OR 4.56, 95% CI 1.43-14.50).
conclusionsPatients presenting to centers with higher mean annual volume of EDTs have improved survival compared with those presenting to institutions with lower mean annual EDT volume. Efforts to understand the etiology of this finding may lead to interventions to improve outcomes at lower-volume centers. LEVEL OF EVIDENCE: Prognostic/Epidemiological, level III; Therapeutic, level IV.
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