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The Changing Face of Trauma: New Orleans Before and After Hurricane Katrina

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Charity Hospital (CH) was devastated by Hurricane Katrina and remains closed. Design and staffing of a new, temporary dedicated trauma hospital relied on data from prior experience at CH, updated census information, and a changed trauma demographic. The study objective was to analyze the new trauma program and evaluate changes in demographics, injury patterns, and outcomes between pre- (PK) and post-Katrina (POK) trauma populations. A retrospective review of trauma patients' demographics, anatomical variables, and physiological variables 6 months PK and POK was performed under an approved Institutional Review Board protocol. Trauma activation triage criteria between study periods were also analyzed. Continuous data comparisons between the two time periods were made with Student's t test. Dichotomous data were analyzed using χ2 test. The demographic of trauma patients is different in the POK interval, reflecting changes in the New Orleans population. Modification of triage criteria by the exclusion of mechanism as an activation criterion resulted in an increase of patients with higher acuity and Injury Severity Score, lower initial Glasgow Coma Score, and a higher proportion of penetrating mechanism. Outcome measures reflect longer length of stay (4.4 vs 6.8 days, P < 0.0001) without a significant difference in mortality (6.0 vs 7.5, P = 0.227). Hospital data demonstrates that the POK trauma system was stressed by the increased acuity, penetrating injury, and number of procedures per patient (1.7 vs 3.4). Resources should be directed toward patients requiring multidisciplinary care by increasing intensive care unit beds and operating room capacity. Future resource planning in the recovery phases of large-scale natural disasters should take into account these observations.
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Document Type: Research Article

Publication date: April 1, 2009

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  • The Southeastern Surgical Congress owns and publishes The American Surgeon monthly. It is the official journal of the Congress and the Southern California Chapter of the American College of Surgeons, which all members receive each month. The journal brings up to date clinical advances in surgical knowledge in a popular reference format. In addition to publishing papers presented at the annual meetings of the associated organizations, the journal publishes selected unsolicited manuscripts. If you have a manuscript you'd like to see published in The American Surgeon select "Information for Authors" from the Related Information options below. A Copyright Release Form must accompany all manuscripts submitted.
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