Concepcion Jennifer, Alfaro Sophie, Selvakumar Sruthi, Newsome Kevin, Sen-Crowe Brendon, Andrade Ryan, Yeager Matthew, Kornblith Lucy, Ibrahim Joseph, Bilski Tracy, Elkbuli Adel
A.T. Still University School of Osteopathic Medicine, Mesa, AZ.
NOVA Southeastern University, Dr. Kiran C. Patel College of Osteopathic Medicine, Fort Lauderdale, FL.
Surgery. 2022 Nov;172(5):1584-1591. doi: 10.1016/j.surg.2022.07.011. Epub 2022 Aug 24.
Motor vehicle collisions remain a leading cause of trauma-related deaths. We aim to investigate the relationship between the proximity of trauma centers to the nearest highway exit and prehospital motor vehicle collision fatalities at the county level nationwide.
This was a cross-sectional study evaluating the association between the distance of trauma centers to the nearest highway exit and prehospital motor vehicle collision fatalities between the years 2014 and 2019. Prehospital motor vehicle collision fatalities were obtained from National Highway Traffic Safety Administration. Mapping software was used to determine the distance of trauma center to the nearest highway exit and transport time. Linear regression analysis was performed.
A total of 2,019 American College of Surgeons-verified and/or state-designated trauma centers were included (211 Level 1, 356 Level 2, 491 Level 3, and 961 Level 4 trauma centers). Prehospital motor vehicle collision fatalities were positively correlated with the distance of trauma center to the nearest highway exit for counties with trauma centers located ≤5 miles from the nearest highway exit (r = 0.328; P < .001). In the 612 counties with a 10% increase in prehospital motor vehicle collision fatalities from 2014 to 2019, prehospital motor vehicle collision fatalities were also positively correlated with distance to the nearest highway exit (r = 0.302; P < .001). The counties with more dispersed distributions of trauma centers were significantly associated with motor vehicle collision fatalities (Spearman's rank coefficient = 0.456; 95% confidence interval, 0.163-0.675; P = .003).
Shorter distances between trauma centers and the nearest highway exit are associated with fewer prehospital motor vehicle collision fatalities for counties with trauma centers ≤5 miles of the nearest highway exit. Further enhancement of existing highway infrastructure and standardization of emergency medical services transport protocols are needed to address the burden of prehospital motor vehicle collision fatalities in the United States.
机动车碰撞仍是创伤相关死亡的主要原因。我们旨在研究创伤中心与最近高速公路出口的距离与全国县级院前机动车碰撞死亡人数之间的关系。
这是一项横断面研究，评估2014年至2019年间创伤中心到最近高速公路出口的距离与院前机动车碰撞死亡人数之间的关联。院前机动车碰撞死亡人数数据来自美国国家公路交通安全管理局。使用地图软件确定创伤中心到最近高速公路出口的距离和运输时间。进行线性回归分析。
共纳入2019个经美国外科医师学会认证和/或州指定的创伤中心（211个一级创伤中心、356个二级创伤中心、491个三级创伤中心和961个四级创伤中心）。对于创伤中心距离最近高速公路出口≤5英里的县，院前机动车碰撞死亡人数与创伤中心到最近高速公路出口的距离呈正相关（r = 0.328；P <.001）。在2014年至2019年间院前机动车碰撞死亡人数增加10%的612个县中，院前机动车碰撞死亡人数也与到最近高速公路出口的距离呈正相关（r = 0.302；P <.001）。创伤中心分布更分散的县与机动车碰撞死亡人数显著相关（斯皮尔曼等级系数 = 0.456；95%置信区间，0.163 - 0.675；P =.003）。
对于创伤中心距离最近高速公路出口≤5英里的县，创伤中心与最近高速公路出口之间的距离越短，院前机动车碰撞死亡人数越少。需要进一步加强现有的公路基础设施建设，并规范紧急医疗服务运输协议，以应对美国院前机动车碰撞死亡的负担。
