Trauma Monthly

Published by: Kowsar

ACS Verified Level I Centers Have Better Clinical Outcomes Than State Designated Level I Trauma Centers

Vaidehi Agrawal 1 , * , Paul J. Deramo 2 , Emily Lowrance 3 , Chanhee Jo Chae 4 and Joseph Darryl Amos 3
Authors Information
1 Clinical Research Institute, Methodist Health System, Dallas, United States
2 Department of Graduate Medical Education, Methodist Dallas Medical Center, Dallas, United States
3 Associates in Surgical Acute Care, Dallas, United States
4 Department of Orthopedics, Texas Scottish Rite Hospital for Children, Dallas, United States
Article information
  • Trauma Monthly: November 2018, 23 (6); e14435
  • Published Online: August 28, 2018
  • Article Type: Research Article
  • Received: June 1, 2017
  • Revised: September 12, 2017
  • Accepted: October 30, 2017
  • DOI: 10.5812/traumamon.14435

To Cite: Agrawal V , Deramo P J, Lowrance E, Chae C J, Amos J D. ACS Verified Level I Centers Have Better Clinical Outcomes Than State Designated Level I Trauma Centers, Trauma Mon. 2018 ; 23(6):e14435. doi: 10.5812/traumamon.14435.

Copyright © 2018, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.
1. Background
2. Methods
3. Results
4. Discussion
  • 1. Tracy EJ. Combining military and civilian trauma systems: the best of both worlds. Adv Emerg Nurs J. 2005;27(3):170-5.
  • 2. Trunkey DD. History and development of trauma care in the United States. Clin Orthopaed Related Res. 2000;374:36-46. doi: 10.1097/00003086-200005000-00005.
  • 3. Trunkey DD. In search of solutions. J Trauma. 2002;53(6):1189-91. doi: 10.1097/01.TA.0000028975.57167.93. [PubMed: 12478052].
  • 4. Hoff WS, Schwab CW. Trauma system development in North America. Clin Orthopaed Related Res. 2004;422:17-22. doi: 10.1097/01.blo.0000128292.43913.83.
  • 5. Demetriades D, Kimbrell B, Salim A, Velmahos G, Rhee P, Preston C, et al. Trauma deaths in a mature urban trauma system: is "trimodal" distribution a valid concept? J Am Coll Surg. 2005;201(3):343-8. doi: 10.1016/j.jamcollsurg.2005.05.003. [PubMed: 16125066].
  • 6. Jurkovich GJ, Mock C. Systematic review of trauma system effectiveness based on registry comparisons. J Trauma. 1999;47(3 Suppl):S46-55. doi: 10.1097/00005373-199909001-00011. [PubMed: 10496611].
  • 7. Mann NC. Assessing the effectiveness and optimal structure of trauma systems: a consensus among experts. J Trauma. 1999;47(3 Suppl):S69-74. doi: 10.1097/00005373-199909001-00015. [PubMed: 10496615].
  • 8. Mann NC, Mackenzie E, Teitelbaum SD, Wright D, Anderson C. Trauma system structure and viability in the current healthcare environment: a state-by-state assessment. J Trauma. 2005;58(1):136-47. doi: 10.1097/01.TA.0000151181.44658.0A. [PubMed: 15674164].
  • 9. American Trauma Society. Trauma Center Levels Explained. ATS; 2016. Available from:
  • 10. Selzer D, Gomez G, Jacobson L, Wischmeyer T, Sood R, Broadie T. Public hospital-based level I trauma centers: financial survival in the new millennium. J Trauma. 2001;51(2):301-7. doi: 10.1097/00005373-200108000-00012. [PubMed: 11493788].
  • 11. American College of Surgeons. Searching for verified trauma centers. ACS; 2016. Available from:
  • 12. Minnesota Department of Health. Minnesota statewide trauma system. MDH; 2016. Available from:
  • 13. Demetriades D, Martin M, Salim A, Rhee P, Brown C, Chan L. The effect of trauma center designation and trauma volume on outcome in specific severe injuries. Ann Surg. 2005;242(4):512-7. discussion 517-9. doi: 10.1097/01.sla.0000184169.73614.09. [PubMed: 16192811]. [PubMed Central: PMC1402347].
  • 14. Mullins RJ. A historical perspective of trauma system development in the United States. J Trauma. 1999;47(3 Suppl):S8-14. doi: 10.1097/00005373-199909001-00004. [PubMed: 10496604].
  • 15. Demetriades D, Martin M, Salim A, Rhee P, Brown C, Doucet J, et al. Relationship between American College of Surgeons trauma center designation and mortality in patients with severe trauma (injury severity score > 15). J Am Coll Surg. 2006;202(2):212-5. quiz A45. doi: 10.1016/j.jamcollsurg.2005.09.027. [PubMed: 16427544].
  • 16. Helling TS, Morse G, McNabney WK, Beggs CW, Behrends SH, Hutton-Rotert K, et al. Treatment of liver injuries at level I and level II centers in a multi-institutional metropolitan trauma system. The Midwest Trauma Society Liver Trauma Study Group. J Trauma. 1997;42(6):1091-6. doi: 10.1097/00005373-199706000-00018. [PubMed: 9210547].
  • 17. Pasquale MD, Peitzman AB, Bednarski J, Wasser TE. Outcome analysis of Pennsylvania trauma centers: factors predictive of nonsurvival in seriously injured patients. J Trauma. 2001;50(3):465-72. discussion 473-4. doi: 10.1097/00005373-200103000-00010. [PubMed: 11265025].
  • 18. Marcin JP, Romano PS. Impact of between-hospital volume and within-hospital volume on mortality and readmission rates for trauma patients in California. Crit Care Med. 2004;32(7):1477-83. doi: 10.1097/01.CCM.0000127781.08985.03. [PubMed: 15241091].
  • 19. Cooper A, Hannan EL, Bessey PQ, Farrell LS, Cayten CG, Mottley L. An examination of the volume-mortality relationship for New York State trauma centers. J Trauma. 2000;48(1):16-23. discussion 23-4. doi: 10.1097/00005373-200001000-00004. [PubMed: 10647560].
  • 20. London JA, Battistella FD. Is there a relationship between trauma center volume and mortality? J Trauma. 2003;54(1):16-24. discussion 24-5. doi: 10.1097/01.TA.0000046313.79663.A4. [PubMed: 12544895].
  • 21. Cudnik MT, Newgard CD, Sayre MR, Steinberg SM. Level I versus Level II trauma centers: an outcomes-based assessment. J Trauma. 2009;66(5):1321-6. doi: 10.1097/TA.0b013e3181929e2b. [PubMed: 19430234].

Featured Image:

Creative Commons License Except where otherwise noted, this work is licensed under Creative Commons Attribution Non Commercial 4.0 International License .

Search Relations:



Create Citiation Alert
via Google Reader

Readers' Comments