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- Title
Involvement of Surgical Residents in the Management of Trauma Patients in the Emergency Room: Does the Presence of an Attending Physician Affect Outcomes?
- Authors
Cohen, Robert; Adini, Bruria; Radomislensky, Irina; Givon, Adi; Rivkind, Avraham; Peleg, Kobi
- Abstract
Background: Few studies have investigated whether the presence or absence of attending physicians (AP) in the emergency department (ED) during the management of trauma patients by residents. Methods: Six level 1 trauma center admissions for years 2006-2008 were analyzed to determine whether presence of an AP affected the time spent in the ED, post-ED disposition, and in-hospital mortality. Results: Patient demographics differed in relation to the presence of APs ( P < 0.01). Patients with ISS > 25 who died during hospitalization were more often managed when APs were present. Male patients, those <65, and patients with Injury Severity Score (ISS) > 16 were more often treated in the presence of an AP ( P < 0.01). Penetrating, terror trauma, motor vehicle collision and assaults were more often managed in the presence APs. Presence of APs differed by hospital ( P < 0.0001). Adjusted logistic regression revealed that patients spent less time in the ED, went directly to the operating room or the ICU for definitive care, if an AP was present. Conclusions: Presence of an attending physician improved and focused patient triage, disposition decisions, and outcomes.
- Subjects
PHYSICIANS; MEDICAL care; EMERGENCY medical services; WOUNDS &; injuries; TRAUMA centers; INTENSIVE care units; MEDICAL emergencies
- Publication
World Journal of Surgery, 2012, Vol 36, Issue 3, p539
- ISSN
0364-2313
- Publication type
Article
- DOI
10.1007/s00268-012-1428-0