Evidence map›Paper›PMID 41130104›Full record

ArticleThe Journal of surgical research2025

Quantifying the Drivers of Survival: A Matched Cohort Study of Trauma Center-Level Differences.

Pawan Acharya, Tabitha Garwe, Sara K Vesely, Janitz Amanda, Jennifer D Peck, Jason S Lees, Barish H Edil, Zain G Hashmi, Alisa M Cross

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of surgical research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

9 authors.

Pawan AcharyaDepartment of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; Division of Trauma and Acute Care Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama. Electronic address: Pawanacharya@uabmc.edu.
Tabitha GarweDepartment of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma; Department of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Sara K VeselyDepartment of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Janitz AmandaDepartment of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Jennifer D PeckDepartment of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Jason S LeesDepartment of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Barish H EdilDepartment of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.
Zain G HashmiDivision of Trauma and Acute Care Surgery, Department of Surgery, University of Alabama at Birmingham, Birmingham, Alabama.
Alisa M CrossDepartment of Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma.

Funding

Tracking and Evaluation CoreU54GM104938 · NIGMS · UNIVERSITY OF OKLAHOMA HLTH SCIENCES CTR · PI Robert Hal Scofield · 2013 to 2026
$68.2M
NIGMS NIH HHS U54 GM104938
6 · The paper itself

Abstract

introductionTertiary trauma centers (levels I and II) offer comprehensive care and are equipped to manage complex injuries. Trauma patients treated at tertiary centers have better survival outcomes. However, the specific interventions driving this advantage remain unknown. This study aimed to identify interventions contributing to differences in short-term mortality between tertiary trauma centers (TTCs) and nontertiary trauma centers (NTCs).

methodsThis was a retrospective cohort study using Trauma Quality Improvement Program data reported between 2017 and 2022. Propensity score matching (1:1, exact) based on injury severity measures paired 12,423 major trauma patients aged 18-54 y, directly admitted from the injury scene to TTCs, with an equal number treated at NTCs. The Oaxaca-Blinder decomposition method was then used to quantify interventions explaining the difference in 7-d mortality between TTCs and NTCs.

resultsIn the propensity-matched sample, the 7-d in-hospital mortality was significantly higher at NTCs (7.04%) than tertiary centers (5.65%), with a risk ratio of 1.25 (95% confidence interval [CI]: 1.13-1.37; P = 0.001). The mortality difference of 1.39 percentage points was explained by a higher proportion of massive blood transfusion (45.67%; 95% CI: 27.98-63.35), airway procedure (44.40%; 95% CI 29.06-49.75), hemorrhage control via laparotomy (30.13%; 95% CI: 16.70-43.56), and other cardiac procedures (4.58%; 95% CI: 2.94-6.21), collectively accounting for 55% of the observed mortality difference.

conclusionsThis study suggests that, for similarly injured patients, massive transfusion, airway management, hemorrhage control via laparotomy, and other cardiac procedures performed at TTCs explain most of the observed survival benefit for patients treated at TTCs.

Indexed as

Hospital MortalityTertiary Care CentersTrauma CentersWounds and InjuriesAdolescentAdultFemaleHumansInjury Severity ScoreMaleMiddle AgedPropensity ScoreQuality ImprovementRetrospective StudiesYoung AdultInterventionOaxaca decompositionPropensity scoreShort-term mortalityTrauma centers

Identifiers

PMID41130104
PMCPMC12616612

What OpenQuestion holds

Textmetadata
LicenceTDM
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.