Effects of Transport to Trauma Centers on Survival Outcomes Among Severe Trauma Patients in Korea: Nationwide Age-Stratified Analysis.
Journal of Korean Medical Science · 2024-02-19 · Registry study
Abstract
BACKGROUND: Previous studies showed that the prognosis for severe trauma patients is better after transport to trauma centers compared to non-trauma centers. However, the benefit from transport to trauma centers may differ according to age group. The aim of this study was to compare the effects of transport to trauma centers on survival outcomes in different age groups among severe trauma patients in Korea. METHODS: Cross-sectional study using Korean national emergency medical service (EMS) based severe trauma registry in 2018-2019 was conducted. EMS-treated trauma patients whose injury severity score was above or equal to 16, and who were not out-of-hospital cardiac arrest or death on arrival were included. Patients were classified into 3 groups: pediatrics (age < 19), working age (age 19-65), and elderly (age > 65). The primary outcome was in-hospital mortality. Multivariable logistic regression analysis was conducted to evaluate the effect of trauma center transport on outcome after adjusting of age, sex, comorbidity, mechanism of injury, Revised Trauma Score, and Injury Severity Score. All analysis was stratified according to the age group, and subgroup analysis for traumatic brain injury was also conducted. RESULTS: Overall, total of 10,511 patients were included in the study, and the number of patients in each age group were 488 in pediatrics, 6,812 in working age, and 3,211 in elderly, respectively. The adjusted odds ratio (95% confidence interval [CI]) of trauma center transport on in-hospital mortality from were 0.76 (95% CI, 0.43-1.32) in pediatrics, 0.78 (95% CI, 0.68-0.90) in working age, 0.71(95% CI, 0.60-0.85) in elderly, respectively. In subgroup analysis of traumatic brain injury, the benefit from trauma center transport was observed only in elderly group. CONCLUSION: We found out trauma centers showed better clinical outcomes for adult and elderly groups, excluding the pediatric group than non-trauma centers. Further research is warranted to evaluate and develop the response system for pediatric severe trauma patients in Korea.
Abstract © the authors or publisher, via PubMed. Reuse and removal
Tags
Children · Mortality & survival · Older adults
Related articles
- Patient choice in the selection of hospitals by 9-1-1 emergency medical services providers in trauma systems. (Acad Emerg Med, 2013)
- Survival advantage for elderly trauma patients treated in a designated trauma center. (J Trauma, 2011)
- A comparison of major trauma patient transport destination in metropolitan Perth, Western Australia. (Australas Emerg Care, 2020)
- Establishing the need for trauma center care: anatomic injury or resource use? (Prehosp Emerg Care, 2008)
- Older age is associated with a reduced likelihood of ambulance transport to a trauma centre after major trauma in Perth. (Emerg Med Australas, 2019)
- Optimizing Trauma Systems: A Geospatial Analysis of the Victorian State Trauma System. (Ann Surg, 2023)