Surgery Today

, Volume 49, Issue 3, pp 261–267 | Cite as

Experienced trauma team leaders save the lives of multiple-trauma patients with severe head injuries

  • Zhi-Jie Hong
  • Cheng-Jueng Chen
  • De-Chuan Chan
  • Teng-Wei Chen
  • Jyh-Cherng Yu
  • Sheng-Der HsuEmail author
Original Article


The trauma team leader is a professional who receives and treats trauma patients. We aimed to evaluate whether or not the seniority of a qualified trauma team leader was a prognostic factor for multiple-trauma patients managed by a trauma team. This was a retrospective cohort study conducted at a Level I Trauma Center in North Taiwan. From January 2009 to December 2013, 284 patients were randomly assigned to one of two trauma team leaders (junior and senior leaders) on duty, irrespective of the seniority of the qualified trauma team leader. All parameters were collected and compared between these two groups. In the subgroup of multiple-trauma patients with Glasgow Coma Scale (GCS) ≤ 8, there were significant differences in the injury severity score, revised trauma score, and seniority of the leader between the alive and dead groups. A multivariate logistic regression analysis showed that the seniority of the trauma team leader was an important mortality risk factor [odds ratio (OR): 14.529, 95% confidence interval (CI) 1.683–125.429, p = 0.015] in patients with GCS ≤ 8. However, in patients with GCS > 8, age was the only independent risk factor [OR: 1.055, 95% CI 1.023–1.087, p = 0.001]. The seniority of the qualified trauma leader is important for teamwork, organization, and efficiency, all of which play an important role in improving the survival outcome of patients with GCS ≤ 8.


Leadership Seniority Trauma team leader Multiple-trauma 



Out-of-hospital cardiac arrest


Injury Severity Score


Glasgow Coma Scale


Revised Trauma Score


Tri-Service General Hospital Institutional Review Board


Emergency department


Advanced trauma life support


Interquartile range


Odds ratio


Confidence interval


Emergency medical technician


Non-technical skills for surgeons



The authors thank Editage (Cactus Communications Pvt., Ltd.), for their assistance with the English language editing.

Author contributions

Conceptualization: Z-JH, S-DH. Methodology: C-JC, S-DH. Validation: D-CC, CML, T-WC, J-CY. Formal analysis: Z-JH, S-DH. Investigation: Z-JH, S-DH. Data curation: Z-JH. Resources: Z-JH, C-JC, S-DH. Writing—original draft: Z-JH. Writing—review and editing: C-JC, S-DH. Supervision: S-DH. Validation: Z-JH, S-DH.


This research was supported in part by the research grant from Tri-Service General Hospital (TSGH-C107-093).

Compliance with ethical standards

Conflict of interest

All authors declare no conflict of interest.

Ethics approval and consent to participate

The study methods were reviewed and approved by the Institutional Review Board II of the Tri-Service General Hospital, National Defense Medical Center (TSGHIRB No. 1-106-05-129).


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Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  • Zhi-Jie Hong
    • 1
    • 2
    • 3
  • Cheng-Jueng Chen
    • 1
    • 2
  • De-Chuan Chan
    • 1
  • Teng-Wei Chen
    • 1
  • Jyh-Cherng Yu
    • 1
  • Sheng-Der Hsu
    • 1
    • 2
    • 4
    Email author
  1. 1.Division of General Surgery, Department of Surgery, Tri-Service General HospitalNational Defense Medical CenterTaipeiTaiwan, ROC
  2. 2.Division of Trauma Surgery, Department of Surgery, Tri-Service General HospitalNational Defense Medical CenterTaipeiTaiwan, ROC
  3. 3.Graduate Institute of Medical SciencesNational Defense Medical CenterTaipeiTaiwan, ROC
  4. 4.Department of Surgery, Tri-Service General HospitalNational Defense Medical CenterTaipeiTaiwan, ROC

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