Article Text

Download PDFPDF

Validation of a predictive model for operative trauma experience to facilitate selection of trauma sustainment military–civilian partnerships
  1. Andrew Hall1,
  2. Iram Qureshi2,
  3. Jacob Glaser2,
  4. Eileen M Bulger3,
  5. Thomas Scalea4,
  6. Stacy Shackelford5,
  7. Jennifer Gurney5
  1. 1Department of Surgery, Saint Louis University Hospital, Eglin AFB, Florida, USA
  2. 2Department of Biomaterials & Epidemiology, Naval Medical Research Unit San Antonio, San Antonio, Texas, USA
  3. 3Department of Surgery, University of Washington, Seattle, Washington, USA
  4. 4Department of Surgery, R Adams Cowley Shock Trauma Center, Baltimore, Maryland, USA
  5. 5Joint Trauma System, Defense Center of Excellence, San Antonio, Texas, USA
  1. Correspondence to Dr Andrew Hall, Surgery, Saint Louis University Hospital, Eglin AFB, FL 32542, USA;{at}


Background Trauma readiness is a Department of Defense requirement for military healthcare providers. Surgeons must maintain readiness to optimize surgical care on the battlefield and minimize preventable death. The objective of this study was to validate a predictive model for trauma operative exposure by applying the model prospectively.

Methods The predictive model for operative trauma exposure was prospectively applied to predict the number of emergent operative cases that would be experienced over predetermined time periods at four separate trauma sustainment military–civilian partnerships (TS-MCP). Notional courses were designed to be 2 or 4 weeks long and consisting of 5 and 12 overnight call periods, respectively. A total of 51 separate 2-week courses and 49 4-week courses were evaluated using the model. The outcome measure was the number of urgent (occurring within a day of arrival) operative trauma cases.

Results Trauma/general surgery case volumes during call periods of notional courses were within the predicted range at least 98% of the time. Orthopedic volumes were more variable with a range of 82%–98% meeting expectation depending on the course length and institution.

Conclusion The previously defined model accurately predicted the number of urgent trauma/general surgery cases course participants would likely experience when applied prospectively to TS-MCP; however, the model was less accurate in predicting acute orthopedic trauma exposure. While it remains unknown how many cases need to be performed meet a trauma sustainment requirement, having a model with a predictive capability for case volume will facilitate metric development. This model may be useful when planning for future TS-MCP.

Level of evidence Economic and Value Based Evaluations Level II

  • surgical training
  • trauma/critical care
  • military

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

View Full Text

Statistics from


  • Contributors AH, IQ, JG, and JG contributed to the planning, conduct, and reporting of the manuscript. EMB, TS, and SS contributed to the reporting of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data may be obtained from a third party and are not publicly available.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.