The effect of organized systems of trauma care on motor vehicle crash mortality

A. Nathens, Gregory Jurkovich, P. Cummings, E. Rivara, R. Maier

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Fatality Analysis Reporting System (PARS) data was analyzed for all US states and the District of Columbia. The analysis was limited to front seat occupants aged 15 to 74, involved in motor vehicle crashes between the dates of 1/1/79 and 12/31/95 who received trauma care at any level. Following an adjustment for age distribution of the population, overall crash mortality decreased by 22% between during the time frame studied. Utilizing the 1993 Inventory of Trauma Systems coupled with a survey that further defined components of a trauma system, the authors identified 22 states that had designated trauma centers and triage policies enforced by legislation. The first year of state trauma center designation was regarded as the year of trauma system implementation. The 22 states identified as having trauma systems had an additional 8% reduction (30% total reduction) during the same time interval. Additionally, 18 of the 22 states with trauma systems had a statistically significant reduction in crash mortality following trauma system implementation. Although the authors state that the initiation of a trauma system had litde or no effect on aggregate crash mortality data during the first 10 years of system development, regression analysis suggests that, after approximately 13 years, the continued projected decrease in crash mortality becomes statistically significant. Because studies had previously related primary or secondary restraint laws, license revocation related to driving under the influence, and speed limits exceeding 55 mph to crash mortality rates, these were considered as possible confounding variables during data analysis. This article supports the conclusions of previous studies supporting the introduction of seat belt, speed limit, and DUI legislation. Data analysis revealed a 13% crash mortality decrease after the enactment of primary seat belt laws or strict DUI regulations. Additionally, states with speed limits exceeding 55 mph were associated with 7% higher crash mortality.

Original languageEnglish (US)
Pages (from-to)105-106
Number of pages2
JournalJournal of Trauma Nursing
Issue number4
StatePublished - Jan 1 2000
Externally publishedYes

ASJC Scopus subject areas

  • Emergency
  • Critical Care
  • Advanced and Specialized Nursing


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