“However,” she said, “as noted by the authors, results should be interpreted with caution. Firstly, the comparison group (non-ACS centers) is very heterogeneous. Non-ACS centers are state accredited. The state accreditation process is extremely variable . . . (and) observed differences may be due to differences in trauma care structure across states rather than between ACS and non-ACS centers.”
“A risk-adjusted comparison of hospital (and ICU) length-of-stay between ACS and non-ACS centers using competitive risk models to account for differences in mortality would have been really interesting,” Dr. Moore said. She also would have liked to see results stratified by injury type and complication type.
Dr. Grossman did not respond to a request for comments.