An analysis of police transport in an Eastern Association for the Surgery of Trauma multicenter trial examining prehospital procedures in penetrating trauma patients - PubMed (original) (raw)

Observational Study

. 2022 Aug 1;93(2):265-272.

doi: 10.1097/TA.0000000000003563. Epub 2022 Jan 31.

Zoe Maher, Amy J Goldberg, Elliott R Haut, Shariq Raza, Grace Chang, Leah C Tatebe, Eman Toraih, Michelle Mendiola, Christofer Anderson, Scott Ninokawa, Patrick Maluso, Jane Keating, Sigrid Burruss, Matthew Reeves, Lauren E Coleman, David V Shatz, Anna Goldenberg-Sandau, Apoorva Bhupathi, M Chance Spalding, Aimee LaRiccia, Emily Bird, Matthew R Noorbakhsh, James Babowice, Marsha C Nelson, Lewis E Jacobson, Jamie Williams, Michael Vella, Kate Dellonte, Thomas Z Hayward 3rd, Emma Holler, Mark J Lieser, John D Berne, Dalier R Mederos, Reza Askari, Barbara Okafor, Eric Etchill, Raymond Fang, Samantha L Roche, Laura Whittenburg, Andrew C Bernard, James M Haan, Kelly L Lightwine, Scott H Norwood, Jason Murry, Mark A Gamber, Matthew M Carrick, Nikolay Bugaev, Antony Tatar, Danielle Tatum

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Observational Study

An analysis of police transport in an Eastern Association for the Surgery of Trauma multicenter trial examining prehospital procedures in penetrating trauma patients

Sharven Taghavi et al. J Trauma Acute Care Surg. 2022.

Abstract

Background: Police transport (PT) of penetrating trauma patients in urban locations has become routine in certain metropolitan areas; however, whether it results in improved outcomes over prehospital Advanced life support (ALS) transport has not been determined in a multicenter study. We hypothesized that PT would not result in improved outcomes.

Methods: This was a multicenter, prospective, observational study of adults (18+ years) with penetrating trauma to the torso and/or proximal extremity presenting at 25 urban trauma centers. Police transport and ALS patients were allocated via nearest neighbor, propensity matching. Transport mode also examined by Cox regression.

Results: Of 1,618 total patients, 294 (18.2%) had PT and 1,324 (81.8%) were by ALS. After matching, 588 (294/cohort) remained. The patients were primarily Black (n = 497, 84.5%), males (n = 525, 89.3%, injured by gunshot wound (n = 494, 84.0%) with 34.5% (n = 203) having Injury Severity Score of 16 or higher. Overall mortality by propensity matching was not different between cohorts (15.6% ALS vs. 15.0% PT, p = 0.82). In severely injured patients (Injury Severity Score ≥16), mortality did not differ between PT and ALS transport (38.8% vs. 36.0%, respectively; p = 0.68). Cox regression analysis controlled for relevant factors revealed no association with a mortality benefit in patients transported by ALS.

Conclusion: Police transport of penetrating trauma patients in urban locations results in similar outcomes compared with ALS. Immediate transport to definitive trauma care should be emphasized in this patient population.

Level of evidence: Prognostic and Epidemiologic; Level III.

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References

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