The effect of transport mode on mortality following isolated penetrating torso Trauma.


Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
10 2023
Historique:
received: 10 04 2023
revised: 12 06 2023
accepted: 26 06 2023
pmc-release: 01 10 2024
medline: 4 9 2023
pubmed: 16 7 2023
entrez: 15 7 2023
Statut: ppublish

Résumé

Prehospital interventions may increase the time to definitive care. Compared to ground ambulance, we hypothesize improved mortality for patients with isolated, penetrating torso injuries transported via private vehicle. We reviewed the National Trauma Data Bank (2017-2021) for adults with isolated, penetrating torso injuries stratified by mechanism (stabbing vs. firearm) and transport mode (private vehicle vs. ground ambulance). We performed a multivariable logistic regression to estimate the effect of transport mode on mortality. 48,444 patients met our inclusion criteria. Patients transported by ambulance, injured by stabbing (n = 26,633) and by firearm (n = 21,811) had adjusted odds ratios of 1.81 (95%CI 1.05-3.14, p = 0.03) and 1.66 (95%CI 1.32-2.09,p < 0.001) respectively for mortality compared to private vehicle transport. Patients with penetrating torso injuries have nearly twice the odds of mortality when transported by ground ambulance than private vehicles, despite injury severity. The "scoop and run" strategy may confer a survival benefit in this population.

Sections du résumé

BACKGROUND
Prehospital interventions may increase the time to definitive care. Compared to ground ambulance, we hypothesize improved mortality for patients with isolated, penetrating torso injuries transported via private vehicle.
METHODS
We reviewed the National Trauma Data Bank (2017-2021) for adults with isolated, penetrating torso injuries stratified by mechanism (stabbing vs. firearm) and transport mode (private vehicle vs. ground ambulance). We performed a multivariable logistic regression to estimate the effect of transport mode on mortality.
RESULTS
48,444 patients met our inclusion criteria. Patients transported by ambulance, injured by stabbing (n = 26,633) and by firearm (n = 21,811) had adjusted odds ratios of 1.81 (95%CI 1.05-3.14, p = 0.03) and 1.66 (95%CI 1.32-2.09,p < 0.001) respectively for mortality compared to private vehicle transport.
CONCLUSION
Patients with penetrating torso injuries have nearly twice the odds of mortality when transported by ground ambulance than private vehicles, despite injury severity. The "scoop and run" strategy may confer a survival benefit in this population.

Identifiants

pubmed: 37453802
pii: S0002-9610(23)00307-0
doi: 10.1016/j.amjsurg.2023.06.033
pmc: PMC10528673
mid: NIHMS1918547
pii:
doi:

Types de publication

Review Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

542-547

Subventions

Organisme : NIGMS NIH HHS
ID : T32 GM008450
Pays : United States

Informations de copyright

Copyright © 2023 Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of competing interest The authors whose names are listed immediately below certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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Auteurs

Kathryn Atkins (K)

Department of Surgery, University of North Carolina at Chapel Hill, United States.

Andrew Schneider (A)

Department of Surgery, University of North Carolina at Chapel Hill, United States.

Jared Gallaher (J)

Department of Surgery, University of North Carolina at Chapel Hill, United States.

Anthony Charles (A)

Department of Surgery, University of North Carolina at Chapel Hill, United States. Electronic address: anthchar@med.unc.edu.

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