Continued rationale of why hospital mortality is not an appropriate measure of trauma outcomes.

Background: We hypothesized that standardized withdrawal of care (WOC) practices and an aggressive long-term acute care facility (LTAC) discharge protocol could change hospital mortality and national ranking among trauma centers.

Study Design: Patients who died while admitted to the trauma service at a level 1 trauma center were classified as either an "LTAC candidate" or "not a LTAC candidate" at 4 time points before death.

Results: A total of 216 patients died, and 48% had WOC.