The Major Trauma Outcome Study

TLDR

The MTOS is a retrospective descriptive study of injury severity and outcomes coordinated by the American College of Surgeons' Committee on Trauma. Data from 80,544 trauma patients were collected from 139 North American hospitals (1982‑1987) and survival probability norms were generated using the Revised Trauma Score, Injury Severity Score, age, and mechanism, with unexpected outcomes identified by comparing observed and expected survivor counts per institution. Motor‑vehicle injuries accounted for 34.7% of cases, 21% were penetrating, overall mortality was 9.0%, and mortality among direct admissions rose from 5% with AIS 3 head injuries to 40% with AIS 4, illustrating the dataset’s utility for injury description and quality‑assurance evaluation.

Abstract

The Major Trauma Outcome Study (MTOS) is a retrospective descriptive study of injury severity and outcome coordinated through the American College of Surgeons' Committee on Trauma. From 1982 through 1987, 139 North American hospitals submitted demographic, etiologic, injury severity, and outcome data for 80,544 trauma patients. Motor vehicle related injuries were more frequent (34.7%). Twenty-one per cent of patients had penetrating injuries. The overall mortality rate was 9.0%. The mortality rate for direct admissions was strongly related to the presence of serious head injury, 5.0% and 40.0%, when head injuries were ± AIS (Abbreviated Injury Scale) 3 or ± AIS 4, respectively. Survival probability norms use the Revised Trauma Score, Injury Severity Score, patient age, and injury mechanism. Patients with unexpected outcomes were identified and statistical comparisons of actual and expected numbers of survivors made for each institution. Results provide a description of injury and outcome and support evaluation and quality assurance activities.