Original ArticlesA Systematic Review and Meta-Analysis Comparing Outcome of Severely Injured Patients Treated in Trauma Centers Following the Establishment of Trauma SystemsCelso, Brian PhD; Tepas, Joseph MD; Langland-Orban, Barbara PhD; Pracht, Etienne PhD; Papa, Linda MD; Lottenberg, Lawrence MD; Flint, Lewis MDAuthor Information From the Department of Surgery (B.C., J.T., L.L., L.F.), University of Florida, Jacksonville, Florida; Department of Health Policy and Management (B.L.-O., E.P.), University of South Florida, Tampa, Florida; Department of Emergency Medicine (L.P.), University of Florida, Gainesville, Florida. Received for publication July 15, 2005. Accepted for publication September 13, 2005. Address for reprints: Brian G. Celso, PhD, University of Florida Surgeons at Melbourne, 1317 Oak Street, Suite 200, Melbourne, FL 32901; email: [email protected]. The Journal of Trauma: Injury, Infection, and Critical Care: February 2006 - Volume 60 - Issue 2 - p 371-378 doi: 10.1097/01.ta.0000197916.99629.eb Buy Metrics Abstract Background: The establishment of trauma systems was anticipated to improve overall survival for the severely injured patient. We systematically reviewed the published literature to assess if outcome from severe traumatic injury is improved for patients following the establishment of a trauma system. Methods: A systematic literature review of all population-based studies that evaluated trauma system performance was conducted. A qualitative analysis of each study's design and methodology and a meta-analysis was performed to evaluate the evidence to date of trauma system effectiveness. Results: A search of the literature yielded 14 published articles. Trauma systems demonstrated improved odds of survival in 8 of the 14 reports. The overall quality-weighted odds ratio was 0.85 lower mortality following trauma system implementation. Conclusions: The results of the meta-analysis showed a 15% reduction in mortality in favor of the presence of a trauma system. Evaluation of trauma system effectiveness must remain an uncompromising commitment to optimal outcome for the injured patient. © 2006 Lippincott Williams & Wilkins, Inc.