TY - JOUR

T1 - Analysis of pre-hospital rescue times on mortality in trauma patients in a Scandinavian urban setting

AU - Bagher, A.

AU - Todorova, L.

AU - Andersson, L.

AU - Clinical Sciences, Malmö, Lund University, Department

AU - Ottosson, A.

AU - Wangefjord, S.

AU - Acosta, S.

N1 - Publisher Copyright: © SAGE Publications.

PY - 2017/1

Y1 - 2017/1

N2 - Objective To analyze if pre-hospital rescue times were associated with mortality in a trauma cohort arriving by ambulance to hospital in a Scandinavian urban setting. Methods Between 2011 and 2013, individuals and pre-hospital rescue times were identified in Emergency Medical Dispatcher Centre, hospital, and forensic records in red alarm trauma. Major trauma was defined as a New Injury Severity Score (NISS)>15. Results Overall, 89% of 378 trauma patients received hospital care within 60 min; 51% had a response time of ≤8 min, and 95% had response time within ≤20 min. The on-scene time (p < 0.05) and total pre-hospital time (p < 0.05) were longer for patients ≥65 years, in comparison with patients <65 years. The patients with penetrating trauma had shorter on-scene time (p < 0.01), total pre-hospital time (p < 0.01), and shorter transport distance from trauma scene to hospital (p = 0.004), compared to those with blunt trauma. Patients with NISS > 15 were found to have the same pre-hospital rescue times as those with NISS ≤ 15. There was a trend that the occurrence of gunshots was associated with increased mortality (p = 0.074). When entering age, NISS, penetrating versus blunt injury, response time, and on-scene time in a multivariate regression analysis, age (p < 0.001), NISS (p < 0.001), and penetrating injury (p = 0.009) remained as independent factors associated with mortality and a trend for shorter on-scene time (p = 0.093). Conclusions Pre-hospital rescue times had less impact on mortality than injury severity, age, and penetrating trauma. Even though penetrating traumas were associated with shorter on-scene time and shorter transport distance to hospital, mortality was increased in this Scandinavian urban setting.

AB - Objective To analyze if pre-hospital rescue times were associated with mortality in a trauma cohort arriving by ambulance to hospital in a Scandinavian urban setting. Methods Between 2011 and 2013, individuals and pre-hospital rescue times were identified in Emergency Medical Dispatcher Centre, hospital, and forensic records in red alarm trauma. Major trauma was defined as a New Injury Severity Score (NISS)>15. Results Overall, 89% of 378 trauma patients received hospital care within 60 min; 51% had a response time of ≤8 min, and 95% had response time within ≤20 min. The on-scene time (p < 0.05) and total pre-hospital time (p < 0.05) were longer for patients ≥65 years, in comparison with patients <65 years. The patients with penetrating trauma had shorter on-scene time (p < 0.01), total pre-hospital time (p < 0.01), and shorter transport distance from trauma scene to hospital (p = 0.004), compared to those with blunt trauma. Patients with NISS > 15 were found to have the same pre-hospital rescue times as those with NISS ≤ 15. There was a trend that the occurrence of gunshots was associated with increased mortality (p = 0.074). When entering age, NISS, penetrating versus blunt injury, response time, and on-scene time in a multivariate regression analysis, age (p < 0.001), NISS (p < 0.001), and penetrating injury (p = 0.009) remained as independent factors associated with mortality and a trend for shorter on-scene time (p = 0.093). Conclusions Pre-hospital rescue times had less impact on mortality than injury severity, age, and penetrating trauma. Even though penetrating traumas were associated with shorter on-scene time and shorter transport distance to hospital, mortality was increased in this Scandinavian urban setting.

KW - mortality

KW - New Injury Severity Score

KW - on-scene time

KW - response time

KW - total pre-hospital time

KW - Trauma

UR - http://www.scopus.com/inward/record.url?scp=85009822116&partnerID=8YFLogxK

U2 - 10.1177/1460408616649217

DO - 10.1177/1460408616649217

M3 - Journal article

AN - SCOPUS:85009822116

VL - 19

SP - 28

EP - 34

JO - Trauma (United Kingdom)

JF - Trauma (United Kingdom)

SN - 1460-4086

IS - 1

ER -