Experienced trauma team leaders save the lives of multiple-trauma patients with severe head injuries
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.
KeywordsLeadership 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
Advanced trauma life support
Emergency medical technician
Non-technical skills for surgeons
The authors thank Editage (Cactus Communications Pvt., Ltd.), for their assistance with the English language editing.
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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