Association between Mode of Transportation and Survival in Adult Trauma Patients with Blunt Injuries: Matched Cohort Study between Police and Ground Ambulance Transport

Author(s):  
Fouad A. Sakr ◽  
Rana H. Bachir ◽  
Mazen J. El Sayed

Abstract Introduction: Early police transport (PT) of penetrating trauma patients has the potential to improve survival rates for trauma patients. There are no well-established guidelines for the transport of blunt trauma patients by PT currently. Study Objective: This study examines the association between the survival rate of blunt trauma patients and the transport modality (police versus ground ambulance). Methods: A retrospective, matched cohort study was conducted using the National Trauma Data Bank (NTDB). All blunt trauma patients transported by police to trauma centers were identified and matched (one-to-four) to patients transported by ground Emergency Medical Services (EMS) for analysis. Descriptive analysis was carried out. This was followed by comparing all patients’ characteristics and their survival rates in terms of the mode of transportation. Results: Out of the 2,469 patients with blunt injuries, EMS transported 1,846 patients and police transported 623 patients. Most patients were 16-64 years of age (86.2%) with a male predominance (82.5%). Fall (38.4%) was the most common mechanism of injury with majority of injuries involving the head and neck body part (64.8%). Fractures were the most common nature of injury (62.1%). The overall survival rate of adult blunt trauma patients was similar for both methods of transportation (99.2%; P = 1.000). Conclusion: In this study, adult blunt trauma patients transported by police had similar outcomes to those transported by EMS. As such, PT in trauma should be encouraged and protocolized to improve resource utilization and outcomes further.

Surgery ◽  
2012 ◽  
Vol 152 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Alessandro Orlando ◽  
Kristin Salottolo ◽  
Phyllis Uribe ◽  
Patricia A. Howell ◽  
Denetta S. Slone ◽  
...  

Author(s):  
Cedric P. Van Dijck ◽  
Lynn G. Stansbury ◽  
Andrew J. Latimer ◽  
Elissa K. Butler ◽  
Rajen Nathwani ◽  
...  

2010 ◽  
Vol 38 (11) ◽  
pp. 2133-2138 ◽  
Author(s):  
Barbara M. Eberle ◽  
Beat Schnüriger ◽  
Bradley Putty ◽  
Galinos Barmparas ◽  
Leslie Kobayashi ◽  
...  

2009 ◽  
Vol 75 (4) ◽  
pp. 307-312 ◽  
Author(s):  
Javid Sadjadi ◽  
Elizabeth L. Cureton ◽  
Patrick Twomey ◽  
Gregory P. Victorino

Blood transfusion has been associated with infection; however, the collinearity of injury severity has not been clearly addressed to show a direct relationship. Using more rigorous analysis, we aimed to untangle the effect of injury severity from transfusion leading to sepsis. We hypothesized that blood transfusion independently increases infection in massively transfused versus nontransfused patients with matched Injury Severity Scores (ISSs). We performed a matched cohort study measuring infection rates in trauma patients receiving massive transfusion. Control subjects were contemporaneous patients with matched ISS receiving no blood. Infection was defined as intraperitoneal or intrathoracic abscesses, pneumonia, urinary tract infection, or bacteremia. Multivariate logistic and univariate analysis was completed. Infection rate was 61 per cent in 44 transfused patients versus 20 per cent in 44 control subjects ( P = 0.001). Odds of infection were eightfold greater in transfused patients (OR, 7.97; 95% CI, 2.3 to 27.5; P < 0.001) independent of ISS, Glasgow Coma Scale, mechanism, and age. Infection was most associated with transfusion of packed red blood cells (PRBCs), although transfusion of other blood products had strong collinearity with PRBCs. Transfused patients had eight times the risk of infection independent of ISS; this appears to be the result of PRBC transfusion. Modifying the ratio of components in transfusion protocols favoring plasma may cause less infection after injury


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