TRAUMA CENTER OUTCOMES AMONG ADULTS HOSPITALIZED AFTER TRAUMA AT WOLFSON HOSPITAL: A RETROSPECTIVE OBSERVATIONAL STUDY

Background: Trauma-related injuries requiring emergency department care remain a major cause of mortality, disability, and healthcare utilization world wide.Trauma centers have reduced preventable mortality, yet outcome variation between hospitals persists. In Israel, national trauma data are centralized by the Gertner Institute. A report received by Wolfson Hospital on August 27, 2017 indicated that mortality among moderately injured patients was threefold higher and among mildly injured patients eightfold higher than that reported for comparable regional trauma centers. Objective: To examine the associations between injury characteristics, patient characteristics,and multiple in-hospital clinical outcomes among adults hospitalized after trauma at Wolfson Hospital. The study was designed as an analysis of associations with three predefined outcomes - discharge destination, length of hospitalization, and expected recovery level - rather than as a mortality-prediction model. Accordingly, mortality was reported descriptively as an important contextual quality indicator, but it was not specified as the primary dependent variable in the analytical model. Because the cohort contained only 37 in-hospital deaths and the available registry dataset did not provide a sufficient event structure for reliable adjusted mortality modeling, no mortality-specific multivariable model was performed. Injury characteristics included injury type and severity according to the Injury Severity Score (ISS). Patient characteristics included age, sex, body mass index (BMI), chronic diseases, and documented risk factors.