The impact of level of the American College of Surgeons Committee on Trauma verification and state designation status on trauma center outcomes

Abstract

The American College of Surgeons (ACS) Committee on Trauma (COT) verification and State designation of trauma centers (TCs) into Level 1 or 2 establishes a distinction based on resources, trauma volume, and educational commitment. The ACS COT and individual states each verify TCs to differentiate performance levels. We aim to determine the relationship between ACS and State Level 1 versus 2, and injury-adjusted, all-cause mortality in a national sampling.TCs were identified by review of the National Sample Program (NSP) from the National Trauma Data Bank (NTDB)-the largest validated trauma database in the nation-of the year 2013. TCs were categorized by ACS or State Level 1 or 2 status, all others were excluded. Adjusted mortality was determined using observed/expected mortality (O/E) ratios, derived by trauma and injury severity score (TRISS) methodology. Chi-squared and t test analyses were used for categorical variables, with a statistical significance defined as P-value