Evidence map›Paper›PMID 37184823›Full record

ArticleCJEM2023

Do patient outcomes differ when the trauma team leader is a surgeon or non-surgeon? A multicentre cohort study.

John Taylor, Recep Gezer, Vesna Ivkov, Mete Erdogan, Samar Hejazi, Robert Green, John M Tallon, Benjamin Tuyp, Jaimini Thakore, Paul T Engels and 8 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in CJEM, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
3.5field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 10 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 11 institutions in 2 countries.

John TaylorRoyal Columbian Hospital Emergency Department, New Westminster, BC, Canada. John.au.taylor@gmail.com.ORCID 0000-0002-1044-5439
Recep GezerTrauma Services BC, Vancouver, BC, Canada.
Vesna IvkovEmergency and Trauma, Fraser Health Authority, Surrey, BC, Canada.
Mete ErdoganNS Health Trauma Program, Implementation Science, Nova Scotia Health, Halifax, NS, Canada.
Samar HejaziDepartment of Evaluation and Research Services, Fraser Health Authority, Surrey, BC, Canada.
Robert GreenDepartments of Critical Care, Emergency Medicine, Anesthesia, and Surgery, Dalhousie University, Halifax, NS, Canada.
John M TallonDepartment of Emergency Medicine, University of British Columbia, Vancouver, BC, Canada.
Benjamin TuypEagle Ridge Hospital, Port Moody, BC, Canada.
Jaimini ThakoreData, Evaluation and Analytics, Trauma Services BC, Fort Langley, BC, Canada.
Paul T EngelsTrauma, General Surgery and Critical Care, Trauma and Acute Care Surgery, McMaster University, Hamilton, ON, Canada.
Alun AckeryDivision of Emergency Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada.
Andrew BeckettUniversity of Toronto, Toronto, ON, Canada.
Kelly VogtWestern University, London, ON, Canada.
Neil ParryTrauma Program, Surgery and Critical Care Medicine, Departments of Surgery and Medicine, Schulich School of Medicine and Dentistry, London Health Sciences Centre, Western University, London, ON, Canada.
Christopher HeydDivision of Emergency Medicine, Department of Medicine, McMaster University, Hamilton, ON, Canada.
Angela CoatesTrauma Program Manager, Hamilton Health Sciences, Hamilton, ON, Canada.
Jacinthe LampronGeneral Surgery, Acute Care and Trauma, The Ottawa Hospital, University of Ottawa, Ottawa, Canada.
Iain MacPhailFraser Health Trauma Network, UBC, Vancouver, BC, Canada.
Fraser Health · CADalhousie University · CAMcMaster University · CAWestern University · CAEagle Ridge Hospital · CAHamilton Health Sciences · CANova Scotia Health Authority · CARoyal Columbian Hospital · CASt. Michael's Hospital · CAUniversity of Ottawa · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTrauma team leaders (TTLs) have traditionally been general surgeons; however, some trauma centres use a mixed model of care where both surgeons and non-surgeons (primarily emergency physicians) perform this role. The objective of this multicentre study was to provide a well-powered study to determine if TTL specialty is associated with mortality among major trauma patients.

methodsData were collected from provincial trauma registries at six level 1 trauma centres across Canada over a 10-year period. We included adult trauma patients (age ≥ 18 yrs) who triggered the highest-level trauma activation. The primary outcome was the difference in risk-adjusted in-hospital mortality for trauma patients receiving initial care from a surgeon versus a non-surgeon TTL.

resultsOverall, 12,961 major trauma patients were included in the analysis. Initial treatment was provided by a surgeon TTL in 57.8% (n = 7513) of cases, while 42.2% (n = 5448) of patients were treated by a non-surgeon TTL. Unadjusted mortality occurred in 11.6% of patients in the surgeon TTL group and 12.7% of patients in the non-surgeon TTL group (OR 0.87, 95% CI 0.78-0.98, p = 0.02). Risk-adjusted mortality was not significantly different between patients cared for by surgeon and non-surgeon TTLs (OR 0.92, 95% CI 0.80-1.06, p = 0.23). Furthermore, we did not observe differences in risk-adjusted mortality for any of the subgroups evaluated.

conclusionsAfter risk adjustment, there was no difference in mortality between trauma patients treated by surgeon or non-surgeon TTLs. Our study supports emergency physicians performing the role of TTL at level 1 trauma centres.

Indexed as

MedicineWounds and InjuriesAdolescentAdultHospital MortalityHumansRegistriesRetrospective StudiesTrauma CentersEmergency medicineMultiple traumaTrauma CentersWounds and injuries

Identifiers

PMID37184823
OpenAlexW4376602312

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.