Association between the mode of transport and in-hospital medical complications in trauma patients: findings from a level-I trauma center in Saudi Arabia

Abstract

BACKGROUNDIn Saudi Arabia, injury is the leading cause of death. Even if nonfatal, the impact of injuries on population health is enormous, as thousands of young patients suffer permanent disabilities every year. Unlike in developed countries, private transportation (PT) is a common means to transport trauma patients. Outcome differences between patients transported via PT relative to emergency medical services (EMS) has not been previously explored.OBJECTIVESTo evaluate the association between transportation mode and in-hospital complications among trauma patients.DESIGNRetrospective.SETTINGTertiary care center.PATIENTS AND METHODSThe study included all patients (≥16 years), who were admitted following trauma.MAIN OUTCOME MEASURESThe main outcome in the study was the occurrence of any medical complications including stroke, sepsis, myocardial infarction, pulmonary embolism, pneumonia, renal failure, acute respiratory distress syndrome, and cardiac arrest.RESULTSThe 493 patients were relatively young (over two-thirds of the sample were 45 years old or younger) and over half the population sustained injuries due traffic crashes. More than half (58%) of patients arrived via private transportation. Regression analyses revealed that in-hospital complications following injuries were significantly lower among those who arrived via PT. However, after incorporating propensity score matching, we found no difference in hospital complications (OR=0.55, 95% CI 0.25–1.17).CONCLUSIONMultiple factors may influence this unexpected finding, such as distance to health care settings, the belief that PT is faster or lack of knowledge of the EMS contact number. Further efforts are needed to raise awareness of the importance of using EMS to transport trauma patients to hospitals. Prevention programs to reduce traffic crashes may facilitate reduction in traumatic injuries and associated complications.LIMITATIONSRetrospective and conducted in one center only.

The associations between injury mechanism and extended hospital stay among pediatric patients: findings from a trauma Center in Saudi Arabia

“…However, it is possible that patients transported by ambulances have more severe injuries than those transported via private vehicles. Approximately two thirds of all of the patients transported to the KAMC came via private transportation, which is similar to the results of a previous local study [34]. This estimate is higher than expected, and it may be explained by a lack of awareness about how to contact emergency services [35].…”

Traumatic Brain Injury Cases' Mortality Predictors, Association, and Outcomes in the Emergency Department at a Tertiary Healthcare Center in Saudi Arabia

“… 24 25 Nonetheless, two regional studies from Riyadh and Oman reported no substantial differences in mortality among injured patients transported by EMS compared with private cars. 26 27 Several important variables should be considered, such as the severity and nature of injuries in patients delivered by EMS, the extrication time, and scene time in patients requiring immediate pre-hospital care. Thus, due to the lack of strong evidence, we are only able to speculate on the possible reasons for our finding of decreased mortality with private transportation of TBI cases, encouraging future reports to further investigate the variables associated with increased mortality among EMS transported patients.…”

Influence of Spatial and Temporal Distance of the Hospital on Survival of Patients with Dangerous Injuries Sustained in Traffic Accidents

“…Prehospital triasis, checking of the patient and adequate estimation of the injury type is an important factor in bringing decision about should the patient be transported into the nearest hospital or specific hospital ( 18 , 28 ).…”