Right Patient, Right Place, Right Time: Field Triage and Transfer to Level I Trauma Centers

The American Surgeon
Benjamin L GoughMark D Cipolle

Abstract

This study sought to compare the outcomes of trauma patients taken directly from the field to a level I trauma center (direct) versus patients that were first brought to a level III trauma center prior to being transferred to a level I (transfer) within our inclusive Delaware trauma system. A retrospective review of the level I center's trauma registry was performed using data from 2013 to 2017 for patients brought to a single level I trauma center from two surrounding counties. The direct cohort consisted of 362 patients, while the transfer cohort contained 204 patients. Linear regression analysis was performed to investigate hospital length of stay (LOS), while logistic regression was used for mortality, complications, and craniotomy. Covariates included age, gender, county, and injury severity score (ISS). Propensity score weighting was also performed between the direct and transfer cohorts. When adjusting for age, gender, ISS, and county, transferred patients demonstrated worse outcomes compared to direct patients in both the regression and propensity score analyses. Transferred patients were at increased risk of mortality (OR 2.17, CI 1.10-4.37, P = .027) and craniotomy (OR 3.92, CI 1.87-8.72, P < .001). Age was predictive...Continue Reading

References

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Aug 11, 2016·Surgery·Molly P JarmanAdil H Haider

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Citations

Apr 17, 2021·The American Journal of Emergency Medicine·Mason SutherlandAdel Elkbuli

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Methods Mentioned

BETA
ISS

Software Mentioned

R twang
R

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