September 21, 2017

Mode of transport to hospital linked to mortality in penetrating trauma patients

Editor's Note

Private vehicle transport was associated with a significantly lower likelihood of death compared with ground emergency medical services (EMS) transport for patients with gunshot and stab wounds in this study.

In this analysis of 103,029 patients in the National Trauma Data Bank, 87.6% were male, 47.9% were black, 26.3% were white, and 18.4% were Hispanic.

Overall, unadjusted mortality was lower for private vehicle transport than for ground EMS (2.2% vs 11.6%). For patients with gunshot wounds, unadjusted mortality was significantly lower for those transported by private vehicle than ground EMS (4.5% vs 9.3%). This difference was also found for stab wound patients (0.2% vs 2.9%).

After risk adjustment, patients with penetrating injuries transported by private vehicle were still significantly less likely to die than patients transported by ground EMS (OR, 0.38). The association remained statistically significant for gunshot (OR, 0.45) and stab wounds (OR, 0.32).

The findings suggest that prehospital trauma care may have a limited role in these patients, the authors note.

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