Comparison of mortality due to severe multiple trauma in two comprehensive models of emergency care: Atlantic Pyrenees (France) and Navarra (Spain).
The Journal of emergency medicine · 2008-10-01 · Observational study
Abstract
BACKGROUND: Injury due to external causes is an important health problem in our society today. Emergency care systems based on the concept of "comprehensive care" can prevent deaths and disabilities as well as limit the severity and pain caused by trauma. OBJECTIVE: To investigate the frequency and characteristics of different mechanisms of injury and to estimate mortality, comparing two comprehensive emergency systems: Atlantic Pyrenees (AP) in France and Navarra (NA) in Spain. MATERIAL AND METHODS: A prospective cohort study of severe multiple-injury patients attended to by the comprehensive emergency care systems of AP and NA from April 1, 2001 to March 31, 2002. Data were collected from personal patient data, the emergency coordination center "112," pre-hospital and hospital health care levels, and discharge data. Bivariate statistical analysis and multivariate logistic regression models were employed for statistical management. RESULTS: There were 614 severe multiple trauma patients recorded, 278 in AP and 336 in NA. Significant differences were observed in arrival time, pre-hospitalization care, pre-hospital Revised Trauma Score (RTS), Injury Severity Score (ISS) at the intensive care unit, and procedures used (intubation, administration of fluids, immobilization, and diagnostic methods). Logistic regression showed significant differences in patient death, age (odds ratio [OR] 1.02, 95% confidence interval [CI] 1.01-1.03), penetrating or accidental injuries, (OR 3.85, 95% CI 1.1-13.1), RTS (OR 0.58, 95% CI 0.5-0.7), and ISS score (OR 1.05, 95% CI 1.0-1.1). CONCLUSION: Despite a more aggressive approach and employment of greater resources, the French comprehensive trauma system does not show greater survival rates among injured patients compared to Navarra, even when controlling for confounding factors like age, injury mechanism, RTS, ISS, and others.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Endotracheal intubation · Intravenous access · Mortality & survival · Time intervals
Related articles
- Prehospital interventions for penetrating trauma victims: a prospective comparison between Advanced Life Support and Basic Life Support. (Injury, 2013)
- Impact of the emergency medical services crew size (2 vs. ≥3 personnel) on prehospital performance and survival in severe trauma: a nationwide cohort study in Korea. (J Trauma Inj, 2026)
- Prehospital care for traumatic cardiac arrest in the US: A cross-sectional analysis and call for a national guideline. (Resuscitation, 2022)
- Stay and play or load and go? The association of on-scene advanced life support interventions with return of spontaneous circulation following traumatic cardiac arrest. (Eur J Trauma Emerg Surg, 2023)
- Does the presence of an emergency physician influence pre-hospital time, pre-hospital interventions and the mortality of severely injured patients? A matched-pair analysis based on the trauma registry of the German Trauma Society (TraumaRegister DGU®). (Injury, 2017)
- Effect of prehospital advanced life support on outcomes of major trauma patients. (J Trauma, 2000)