Significance of orthopedic trauma specialists in trauma centers in Korea

Abstract

Introduction In 2012, the Korean central government selected trauma centers to provide effective treatment and reduce preventable mortality in severe trauma patients. General surgeons, thoracic surgeons, orthopedists, and neurosurgeons play pivotal roles in trauma centers, as most trauma patients require orthopedic procedures. This study aimed to underscore the importance of trauma orthopedic specialists (TOSs) by comparing treatment outcomes between a TOS and general orthopedists.

Patients and methods Orthopedic trauma patients with injury severity scores > 15 points, admitted to level 1 trauma centers between March 2015 and December 2016, were divided into the TOS group (treated by 1 orthopedic trauma specialist who treats trauma patients with no limitation in the joint of specialization) and the general orthopedist group (GOG; treated by several general orthopedists who manage both trauma and disease but are each specialized in a certain joint). Emergency room response time, triage time, surgical preparation time, number of surgeries per patient, intensive care unit (ICU) duration, complications, and mortality were retrospectively analyzed.

Results Among 272 patients, 52 were treated by a TOS and 220 were treated by several general orthopedists. For the TOS group and the GOG, the average emergency room response time was 8 and 32 min; average triage time, 27 and 162 min; average surgical preparation time, 141 and 350 min; average number of surgeries per patient, 1.9 and 2.7; and average ICU duration, 8.5 and 12.2 days, respectively. The TOS group saved $2700 per patient. No statistical differences were found in complications and mortality between the 2 groups.

Conclusions TOSs can provide rapid treatment to trauma patients and systemically participate in collaborative treatment with other specialists in a trauma center. As treatment provided by a TOS can also reduce the ICU duration, TOSs can play an important role in rapid rehabilitation and cost reduction for trauma patients.