Outcome variation among Canadian trauma centres: toward a clinical prediction rule for standardizing approaches to clinical assessment of hemorrhage

Dufresne and colleagues1 recently reported on the impact of trauma centre designation on patient-centred outcomes following hemorrhagic shock. The authors showed that patients treated at level I trauma centres had significantly lower odds of dying than those treated at lower-level centres — findings consistent with previous work. The authors hypothesized that differences in outcomes were associated with the initial assessment and management, where higher surgical volumes, greater clinical expertise and availability of resources, such as computed tomography (CT), could play an important role