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St. Michael’s trauma survival among top in North America

Toronto, December 17, 2014

By Leslie Shepherd

Blurred hospital staff speed down the hallway of a trauma centre with a patient on a stretcher
Photo from BigStock.com

Trauma patients who come to St. Michael’s Hospital have a better chance of surviving than those at almost any other comparable trauma centre in North America, new figures show. An astounding 90 per cent better chance.

The figures come from the American College of Surgeons Trauma Quality Improvement Program, which tracks the performance of more than 220 North American trauma centres in three areas – mortality, complications and care process. The results are then risk-adjusted so hospitals can compare themselves against other centres with a similar patient population. St. Michael’s is the only Canadian hospital participating in the program.

The statistics for October 2013 to September 2014 show the hospital’s all-cause mortality rate is lower than 90 per cent of other centres and its complication rates are dropping over previous years, said Dr. Sandro Rizoli, director of trauma.

Several initiatives contributed to St. Michael’s excellent statistics, said Sonya Canzian, program director for trauma and neurosurgery.

First, the hospital has undertaken a quality initiative to prevent blood clots in patients who are immobile for long periods of time, making sure they get blood thinners at the right time – not too early so that they cause bleeding and not too late after clots have already formed.

The Trauma Quality Improvement Program figures show that 78.5 per cent of eligible patients at St. Michael’s receive venous thromboembolism prophylaxis, compared to 56.6 per cent at similar trauma centres. For patients with traumatic brain injuries, where bleeding is of special concern, 54 per cent of St. Michael’s trauma patients received VTE prophylaxis compared with 28.6 per cent at other centres.

Second, only 4.5 per cent of St. Michael’s trauma patients wait more than 24 hours for surgery to repair femur fractures, compared with 30.9 per cent in other centres. Only 33.3 per cent of patients with an open tibia or fibula fracture waited more than 12 hours for surgery, compared with 51 per cent for all TQIP centres.

“We have a culture of prioritizing trauma patients, including dedicated OR time,” Canzian said. “This is a huge commitment involving everyone from the ED to orthopedics and Perioperative Services to make this happen.”

Third, St. Michael’s uses leading edge technology and best practices to monitor inter-cranial pressure in TBI patients to detect brain swelling as soon as possible. ICP monitors were inserted into the brain in 21 per cent of St. Michael’s patients with head injuries compared to 16 per cent in other centres.

The spleen was preserved in 82 per cent of St. Michael’s patients compared with 78 per cent in other centres.

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.