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Providing systems of trauma care has improved outcomes for severely injured patients, yet not all trauma centers have dedicated in-patient trauma services. In this retrospective Australian study, the authors compared mortality among severely injured (Injury Severity Score >15) patients who were admitted to at a single level 1 trauma center during three periods with distinct systems of care: evaluation by a general surgeon with admission to a general surgical service (2002–2004); evaluation by a trauma specialist with admission to a general surgical service (2005–2007); and evaluation by a trauma specialist with admission to a dedicated specialist trauma service (2008–2011).
Of 3869 severely injured patients, 39% were critically injured (ISS …