Y. M. Wong2, S. K. Madiraju1, D. Livingston3, R. Albrecht4, D. Ciesla5, J. Davis6, R. Dicker7, A. Eastman8, R. Kozar9, M. Lorenzo10, F. Moore11, S. Savage12, T. Scalea9, M. Schreiber13, D. Shatz14, N. Namias1,2, E. Ginzburg1,2 1University of Miami,School Of Medicine,Miami, FL, USA 2Jackson Memorial Hospital,Trauma And Surgical Critical Care,Miami, FL, USA 3University Hospital,Trauma And Critical Care,Newark, NJ, USA 4University Of Oklahoma College Of Medicine,Trauma And Surgical Critical Care,Oklahoma City, OK, USA 5University Of South Florida College Of Medicine,Trauma And Surgical Critical Care,Tampa, FL, USA 6University of California – San Francisco, Fresno,Trauma And Surgical Critical Care,Fresno, CA, USA 7University Of California – Los Angeles,Trauma And Surgical Critical Care,Los Angeles, CA, USA 8University Of Texas Southwestern Medical Center,Trauma And Critical Care,Dallas, TX, USA 9University Of Maryland,School Of Medicine,Baltimore, MD, USA 10Methodist Dallas Medical Center,Trauma Surgery,Dallas, TX, USA 11University Of Florida,Department Of Surgery,Gainesville, FL, USA 12Indiana University School Of Medicine,School Of Medicine,Indianapolis, IN, USA 13Oregon Health And Science University,Trauma, Critical Care And Acute Care Surgery,Portland, OR, USA 14University Of California – Davis,Department Of Surgery,Sacramento, CA, USA
Introduction: The American College of Surgeons Committee on Trauma (ACS COT) developed a Needs Based Assessment Tool (NBAT) to provide evidence based resource allocation. Recent study has shown an inverse relationship between increasing volume and mortality rates at Levels 1 and 2 trauma centers (TC). However, this study did not address the relationship of volume with measurement of trauma fellow experience at Level 1 academic trauma centers (L1ATC). Any diminution of training may negatively impact future trauma surgeons’ preparedness. The goal of this work was to define the current experience of fellows at L1ATCs as potential thresholds for future refinements of NBATs.
Methods: A survey requesting 2016 caseloads and fellow numbers was collected from 12 L1ATC trauma program managers and trauma directors.
Results: Median and interquartile range (IQR) for total number of cases and cases/fellow ratio (CFR) are presented in Table 1. Median absolute cases with injury severity score (ISS) > 15 = 676 (IQR 454, 796). Median CFR with ISS > 15 = 226 (IQR 153, 312).
Conclusion: We propose that maintaining ≥ 650 admissions/center and ≥ 225 admissions/fellow of patients with an ISS > 15 at existing L1ATC be considered before introducing new TC to a region. This survey provides an additional baseline for ACS COT to evaluate the impact on training volumes as part of the verification process and trauma system design.
