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David V. Feliciano, MD

Arch Surg. 2009;144(8):764-765.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Haut et al are to be congratulated for a comprehensive analysis of the changes that occurred in their trauma center after the introduction of new leadership and structure in 1998. The experience of the in-house trauma attending surgeon did not have an effect on overall patient mortality, whereas the change in leadership and structure decreased mortality when novice surgeons were the caregivers. The use of mortality as an end point in analyzing trauma care does have some limitations. For example, it would be helpful to know the actual percentages of blunt vs gunshot wound vs stab wound mechanisms of injury in all groups. Patients with hypotension in the former 2 groups have significant mortality compared with the latter group when the admission base deficit exceeds –15. It would be expected that the greatest advantage of having an experienced surgeon available would be in the performance of . . . [Full Text of this Article]

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Surgeon- and System-Based Influences on Trauma Mortality
Elliott R. Haut, David C. Chang, Awori J. Hayanga, David T. Efron, Adil H. Haider, and Edward E. Cornwell, III
Arch Surg. 2009;144(8):759-764.
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