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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 Hsu
Original Article
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Abstract

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.

Keywords

Leadership Seniority Trauma team leader Multiple-trauma 

Abbreviations

OHCA

Out-of-hospital cardiac arrest

ISS

Injury Severity Score

GCS

Glasgow Coma Scale

RTS

Revised Trauma Score

TSGHIRB

Tri-Service General Hospital Institutional Review Board

ED

Emergency department

ATLS

Advanced trauma life support

IQR

Interquartile range

OR

Odds ratio

CI

Confidence interval

EMT

Emergency medical technician

NOTSS

Non-technical skills for surgeons

Notes

Acknowledgements

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.

Funding

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
  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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