World Journal of Surgery

, Volume 36, Issue 3, pp 539–547

Involvement of Surgical Residents in the Management of Trauma Patients in the Emergency Room: Does the Presence of an Attending Physician Affect Outcomes?

Authors

    • Israel National Center for Trauma and Emergency Medicine ResearchGertner Institute for Epidemiology and Health Policy Research
  • Bruria Adini
    • Ministry of Health, Emergency Medical Services and Disaster Management Division
  • Irina Radomislensky
    • Israel National Center for Trauma and Emergency Medicine ResearchGertner Institute for Epidemiology and Health Policy Research
  • Adi Givon
    • Israel National Center for Trauma and Emergency Medicine ResearchGertner Institute for Epidemiology and Health Policy Research
  • Avraham I. Rivkind
    • Department of SurgeryHadassah Medical Organization
  • Kobi Peleg
    • Israel National Center for Trauma and Emergency Medicine ResearchGertner Institute for Epidemiology and Health Policy Research
Article

DOI: 10.1007/s00268-012-1428-0

Cite this article as:
Cohen, R., Adini, B., Radomislensky, I. et al. World J Surg (2012) 36: 539. doi:10.1007/s00268-012-1428-0

Abstract

Background

Few studies have investigated whether the presence or absence of attending physicians (AP) in the emergency department (ED) during the management of trauma patients by residents.

Methods

Six level 1 trauma center admissions for years 2006–2008 were analyzed to determine whether presence of an AP affected the time spent in the ED, post-ED disposition, and in-hospital mortality.

Results

Patient demographics differed in relation to the presence of APs (P < 0.01). Patients with ISS > 25 who died during hospitalization were more often managed when APs were present. Male patients, those <65, and patients with Injury Severity Score (ISS) > 16 were more often treated in the presence of an AP (P < 0.01). Penetrating, terror trauma, motor vehicle collision and assaults were more often managed in the presence APs. Presence of APs differed by hospital (P < 0.0001). Adjusted logistic regression revealed that patients spent less time in the ED, went directly to the operating room or the ICU for definitive care, if an AP was present.

Conclusions

Presence of an attending physician improved and focused patient triage, disposition decisions, and outcomes.

Copyright information

© Société Internationale de Chirurgie 2012