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Prehospital transportation decisions for patients sustaining major trauma in road traffic crashes in Sweden

Stefan Candefjord (Institutionen för signaler och system, Biomedicinsk elektromagnetik) ; Ruben Buendia (Institutionen för signaler och system, Medicinska signaler och system) ; Eva Corina Caragounis ; Bengt Arne Sjöqvist (Institutionen för signaler och system, Medicinska signaler och system) ; Helen Fagerlind (SAFER - Fordons- och Trafiksäkerhetscentrum )
Traffic Injury Prevention (1538-9588). Vol. 17 (2016), S1, p. 16-20.
[Artikel, refereegranskad vetenskaplig]

Objective: The objective of this study was to evaluate the proportion and characteristics of patients sustaining major trauma in road traffic crashes (RTCs) who could benefit from direct transportation to a trauma center (TC).Methods: Currently, there is no national classification of TC in Sweden. In this study, 7 university hospitals (UHs) in Sweden were selected to represent a TC levelI or levelII. These UHs have similar capabilities as the definition for level I and level II TC in the United States. Major trauma was defined as Injury Severity Score (ISS) > 15. A total of 117,730 patients who were transported by road or air ambulance were selected from the Swedish TRaffic Accident Data Acquisition (STRADA) database between 2007 to 2014. An analysis of the patient characteristics sustaining major trauma in comparison with patients sustaining minor trauma (ISS < 15) was conducted. Major trauma patients transported to a TC versus non-TC were further analysed with respect to injured body region and road user type.Results: Approximately 3% (n = 3, 411) of patients sustained major trauma. Thirty-eight percent of major trauma patients were transported to a TC, and 62% were transported to a non-TC. This results in large proportions of patients with Abbreviated Injury Scale (AIS) 3+ injuries being transported to a non-TC. The number of AIS 3+ head injuries for major trauma patients transported to a TC versus non-TC were similar, whereas a larger number of AIS 3+ thorax injuries were present in the non-TC group. The non-TC major trauma patients had a higher probability of traveling in a car, truck, or bus and to be involved in a crash in a rural location.Conclusions: Our results show that the majority of RTC major trauma patients are transported to a non-TC. This may cause unnecessary morbidity and mortality. These findings can guide the development of improved prehospital treatment guidelines, protocols and decision support systems.

Nyckelord: Major trauma, road traffic crashes, prehospital care, trauma center, triage, post-crash



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Denna post skapades 2016-10-14. Senast ändrad 2016-11-06.
CPL Pubid: 243411

 

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Institutioner (Chalmers)

Institutionen för signaler och system, Biomedicinsk elektromagnetik
Institutionen för signaler och system, Medicinska signaler och system
Institutionen för kliniska vetenskaper, sektionen för kirurgi och kirurgisk gastroforskning (GU)
SAFER - Fordons- och Trafiksäkerhetscentrum

Ämnesområden

Livsvetenskaper
Transport
Annan medicin och hälsovetenskap

Chalmers infrastruktur