학술논문

The conference effect: National surgery meetings are associated with increased mortality at trauma centers without American College of Surgeons verification.
Document Type
Article
Source
PLoS ONE. 3/26/2019, Vol. 14 Issue 3, p1-12. 12p.
Subject
*TRAUMA centers
*HEALTH facilities
*HOSPITAL mortality
*FORUMS
*PHYSICIANS
*AIRPLANE ambulances
Language
ISSN
1932-6203
Abstract
Background: Thousands of physicians attend scientific conferences each year. While recent data indicate that variation in staffing during such meetings impacts survival of non-surgical patients, the association between treatment during conferences and outcomes of a surgical population remain unknown. The purpose of this study was to examine mortality resulting from traumatic injuries and the influence of hospital admission during national surgery meetings. Study design: Retrospective analysis of in-hospital mortality using data from the Trauma Quality Improvement Program (2010–2011). Identified patients admitted during four annual meetings and compared their mortality with that of patients admitted during non-conference periods. Analysis included 155 hospitals with 12,256 patients admitted on 42 conference days and 82,399 patients admitted on 270 non-conference days. Multivariate analysis performed separately for hospitals with different levels of trauma center verification by state and American College of Surgeons (ACS) criteria. Results: Patient characteristics were similar between meeting and non-meeting dates. At ACS level I and level II trauma centers during conference versus non-conference dates, adjusted mortality was not significantly different. However, adjusted mortality increased significantly for patients admitted to trauma centers that lacked ACS trauma verification during conferences versus non-conference days (OR 1.2, p = 0.008), particularly for patients with penetrating injuries, whose mortality rose from 11.6% to 15.9% (p = 0.006). Conclusions: Trauma mortality increased during surgery conferences compared to non-conference dates for patients admitted to hospitals that lacked ACS trauma level verification. The mortality difference at those hospitals was greatest for patients who presented with penetrating injuries. [ABSTRACT FROM AUTHOR]