Major Trauma Outcome Study

[Jeffery Hammond]

MTOS is getting long in the tooth and its flaws are well documentd; and the
NTDB is not a normative dataset. There really is not "national standard" as
such. 

Check out the ACS COT website and look at the material posted by the
Outcomes and the PIPS subcommittees.

Jeffrey Hammond MD, MPH, FACS 

-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Bob Waddell II
Sent: Thursday, March 06, 2008 1:28 PM
To: 'Trauma & Critical Care mailing list'
Subject: RE: Major Trauma Outcome Study

Dr. Matthews,

I sent your questions to Dr. Bill Sacco, who has extensive experience with
the various trauma data bases, data analysis, and trauma management
processes.  He recommended you contact Dr. John Fildes (JFildes at med.unr.edu
).  Dr. Fildes is the Chair of National Trauma Database, Director of the
University of Nevada Trauma Center, and highly regarded within the ASC and
Trauma world.  Hope this helps.

Take care, 
  
Bob 
  
Robert K. Waddell II
Vice President -
Emergency Preparedness and Response
"The Sacco Triage Methodology" 
ThinkSharp, Inc 
  
Wyoming Office: 
1302 East 5th Avenue
Cheyenne, Wyoming 82001
(307) 920 - 2020 cell 

bwaddell at sharpthinkers.com
or bobwaddell at bresnan.net
www.sharpthinkers.com 


-----Original Message-----
From: trauma-list-bounces at trauma.org [mailto:trauma-list-bounces at trauma.org]
On Behalf Of Marc Matthews - MedPro MMC X
Sent: Thursday, March 06, 2008 7:38 AM
To: trauma-list at trauma.org
Subject: Major Trauma Outcome Study

All,
 
I need some advice. I am trying to compare our institution's trauma results
to a reference standard or a national trauma standard. My statistician used
the Major Trauma Outcome Study to calculate z, w and m scores (J Trauma.
<javascript:AL_get(this, 'jour', 'J Trauma.');>  1990 Nov;30(11):1356-65).
The study was  conducted from 1982 to 1987 using 139 North American
hospitals submitting demographic, etiologic, injury severity and outcome
data from over 80,000 trauma patients. Our scores were favorable, but I have
concerns.
 
My question is as the Major Trauma Outcome Study was done in the mid to late
80's and published in 1990, is this study still acceptable for comparison or
is there another more recent study for comparison? How is everyone else
comparing themselves to this standard, and if not how are you doing
comparing yourself, and if not why are centers not comparing? 
 
As we are pushing for ACS COT verification this year at this institution, I
want to be sure that our trauma care is meeting the national standard, but
need some guidance as to what others are doing and what standard are they
using. Our worry is that we are missing something that we should be doing.
 
Any help would be greatly appreciated. I hope that this is not too
elementary of an e-mail.
 
Thank you for your time as any advice would be greatly appreciated.
 
Sincerely,

Marc R. Matthews, MD
Medical Director, Trauma Services, Maricopa Medical Center Medical Director,
Respiratory Care Services, Maricopa Medical Center Associate Director,
Arizona Burn Center, Maricopa Medical Center 

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