Pre-hospital time intervals in trauma patient transportation by emergency medical service: association with the first ۲۴-hour mortality

Objective: Most previous retrospective studies failed to show a consistent association between pre-hospital time intervals and mortality in trauma patients, bringing the recommendation of “transport fast to increase survival” under question. The aim of this study was to evaluate the association of response time, scene time, and transport time with ۲۴-hour in-hospital mortality.Methods: In this cross-sectional study data were collected In the emergency department (ED). Time intervals were obtained from emergency medical service (EMS) central system. All traumatized patients presented to an urban academic hospital by EMS with Emergency Severity Index (ESI) levels ۱ or ۲ were included in the study. Exclusion criteria were age under ۱۶ or above ۶۵, being transported from outside of the city, severe underlying medical illness, life threatening intoxications, and randomized trauma score (RTS) of more than ۱۰. Patients were followed in the hospital for ۲۴-hour mortality.Results: A total of ۲۸۸۴ patients were enrolled in the study. Response time, scene time, transport time, and total out of hospital time were all associated with mortality in univariate analysis (P = ۰.۰۲, ۰.۰۱, <۰.۰۰۱, and ۰.۰۰۱, respectively). In multivariate regression analysis, transport time was associated with ۲۴-hour mortality (P < ۰.۰۰۱, OR [۹۵% CI]: ۱.۲۰ [۱.۱۶-۱.۲۴]).Conclusion: Although time intervals in most previous studies did not show association with mortality, there is no recommendation such as “pre-hospital time intervals in traumatized patients should not be limited,” since limiting time intervals for taking a traumatized patient to the hospital still seems to be prudent. Our findings support the recommendation of decreasing the transportation and total out of hospital time in the present condition in Kerman city EMS system.

کلیدواژه ها:

Prehospital emergency care ، Time-to-treatment ، Trauma ، Transportation ، Emergency medical service