Rahhal Romy, Sakr Paul, Bachir Rana, El Sayed Mazen
Department of Emergency Medicine Northeast Georgia Medical Center Gainesville Georgia USA.
Faculty of Medicine University of Balamand El-Koura Lebanon.
Acute Med Surg. 2025 May 8;12(1):e70061. doi: 10.1002/ams2.70061. eCollection 2025 Jan-Dec.
AIM: Blunt injuries constitute a major cause of death in the United States. Regionalization in trauma systems improves patients' survival and outcomes. Limited data exist on the impact of mode of transport in regionalized trauma systems. This study examines the association between trauma designation levels and survival to hospital discharge of patients with blunt trauma transported by police or ground ambulance. METHODS: This retrospective-matched cohort study used the 2017 National Trauma Data Bank dataset. Adult blunt trauma patients transported by police were identified and matched (one-to-four) to those transported by ground ambulance. Demographic characteristics, injury, and clinical data were described and compared according to trauma designation levels. The survival rate was determined by the transport mode and/or the trauma designation levels. RESULTS: A total of 5316 blunt trauma patients were included. Mean age was 41.8 (±16.5) years, and most were males (81.8%). Most patients were transported to Level I centers and were more likely to be admitted (91.1%) compared to those transported to level II and level III trauma centers (87.5%). They also had a lower survival rate compared with the latter group ((98.7%) vs. (99.7%), = 0.001). Survival rates were similar when comparing patients by mode of transport ( = 0.785). This remained unchanged after stratifying by the trauma designation levels ( > 0.05). CONCLUSIONS: Adult patients with blunt trauma transported by police or ground ambulance had similar survival across different trauma level centers. Increased police involvement in the transport of blunt trauma patients is recommended.
目的:钝性损伤是美国主要的死亡原因之一。创伤系统的区域化可提高患者的生存率和治疗效果。关于区域化创伤系统中运输方式的影响,现有数据有限。本研究探讨创伤指定级别与由警察或地面救护车运送的钝性创伤患者出院生存率之间的关联。 方法:这项回顾性匹配队列研究使用了2017年国家创伤数据库数据集。确定由警察运送的成年钝性创伤患者,并与由地面救护车运送的患者进行(一对一至四)匹配。根据创伤指定级别描述并比较人口统计学特征、损伤情况和临床数据。通过运输方式和/或创伤指定级别确定生存率。 结果:共纳入5316例钝性创伤患者。平均年龄为41.8(±16.5)岁,大多数为男性(81.8%)。大多数患者被送往一级中心,与送往二级和三级创伤中心的患者相比,更有可能被收治(91.1%)。与后一组相比,他们的生存率也较低((98.7%)对(99.7%),P = 0.001)。按运输方式比较患者时,生存率相似(P = 0.785)。按创伤指定级别分层后,这一情况保持不变(P>0.05)。 结论:由警察或地面救护车运送的成年钝性创伤患者在不同创伤级别中心的生存率相似。建议增加警察参与钝性创伤患者的运输。
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