Mortality of trauma patients treated at trauma centers compared to non-trauma centers in Sweden: a retrospective study
Journal article, 2022

Objective: The main objective was to compare the 30-day mortality rate of trauma patients treated at trauma centers as compared to non-trauma centers in Sweden. The secondary objective was to evaluate how injury severity influences the potential survival benefit of specialized care. Methods: This retrospective study included 29,864 patients from the national Swedish Trauma Registry (SweTrau) during the period 2013–2017. Three sampling exclusion criteria were applied: (1) Injury Severity Score (ISS) of zero; (2) missing data in any variable of interest; (3) data falling outside realistic values and duplicate registrations. University hospitals were classified as trauma centers; other hospitals as non-trauma centers. Logistic regression was used to analyze the effect of trauma center care on mortality rate, while adjusting for other factors potentially affecting the risk of death. Results: Treatment at a trauma center in Sweden was associated with a 41% lower adjusted 30-day mortality (odds ratio 0.59 [0.50–0.70], p < 0.0001) compared to non-trauma center care, considering all injured patients (ISS ≥ 1). The potential survival benefit increased substantially with higher injury severity, with up to > 70% mortality decrease for the most critically injured group (ISS ≥ 50). Conclusions: There exists a potentially substantial survival benefit for trauma patients treated at trauma centers in Sweden, especially for the most severely injured. This study motivates a critical review and possible reorganization of the national trauma system, and further research to identify the characteristics of patients in most need of specialized care.

Trauma center



Trauma system




Stefan Candefjord

Chalmers, Electrical Engineering, Signal Processing and Biomedical Engineering

Linn Asker

Sahlgrenska University Hospital

Eva Corina Caragounis

Sahlgrenska University Hospital

European Journal of Trauma and Emergency Surgery

1863-9933 (ISSN) 16153146 (eISSN)

Vol. 48 1 525-536

Subject Categories

Anesthesiology and Intensive Care

General Practice

Areas of Advance

Health Engineering



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Latest update

4/5/2022 5