Addition of a general surgeon without addition of appropriate support is inadequate to improve outcomes of trauma patients in a rural setting: a cohort study of 1962 consecutive patients.

Purpose: Trauma care poses many challenges in small hospitals in rural settings. This report was designed to assess the role of a rural general surgeon with trauma patients.
Methods: A cohort study was designed using a retrospective analysis of a cohort at Bozkır Community Hospital that included trauma patients admitted to the emergency department between June 2007 and May 2009. The patients of group 1 were those treated during the first year of the study period, when the hospital staff was only non-specialist physicians. In the second year, a general surgeon was added to the staff, and the patients from this period constituted group 2.
Results: The top three leading causes of injuries were falls (46.5 %), piercing/cutting injuries (38.2 %), and assault (6.5 %). The frequency of trauma due to falls was higher in group 1, and assault and piercing/cutting injuries were higher in group 2 (p < 0.001 for each). The percentage of discharged and transferred patients was not significantly different between groups (p = 0.065 and p = 0.082, respectively). Similar mortality rates were also detected (group 1: 0.5 %, group 2: 0.3 %, p = 0.479).
Conclusions: The presence of a solo general surgeon was not found to be adequate for improving the outcome for trauma patients in a rural hospital.