Effects of advanced life support versus basic life support on the mortality rates of patients with trauma in prehospital settings: a study protocol for a systematic review and meta-analysis

Abstract

IntroductionAdvanced life support (ALS) is thought to be associated with improved survival in prehospital trauma care when compared with basic life support (BLS). However, evidence on the benefits of prehospital ALS for patients with trauma is controversial. Therefore, we aim to clarify if ALS improves mortality in patients with trauma when compared with BLS by conducting a systematic review and meta-analysis of the recent literature.Methods and analysisWe will perform searches in PubMed, Embase and the Cochrane Central Register of Controlled Trials for published observational studies, controlled before-and-after studies, randomised controlled trials and other controlled trials conducted in humans and published until March 2017. We will screen search results, assess study selection, extract data and assess the risk of bias in duplicate; disagreements will be resolved through discussions. Data from clinically homogeneous studies will be pooled using a random-effects meta-analysis, heterogeneity of effects will be assessed using the χ2 test of homogeneity, and any observed heterogeneity will be quantified using the I2 statistic. Last, the Grading of Recommendations Assessment, Development and Evaluation approach will be used to rate the quality of the evidence.Ethics and disseminationOur study does not require ethical approval as it is based on findings of previously published articles. Results will be disseminated through publication in a peer-reviewed journal, presentations at relevant conferences and publications for patient information.Trial registration numberPROSPERO (International Prospective Register of Systematic Reviews) registration number CRD42017054389.

Hospital Risk Factors Affecting Mortality and Morbidity in Polytraumatized Patients and Their Outcome

“…Severe trauma is a major global public health issue, contributing to about 1 in 10 mortalities and resulting in the annual worldwide death of more than 5.8 million people (1) . Before arrival at the hospital, the availability of advanced life support does not greatly improve the outcome for major trauma when compared to the administration of basic life support (2) .…”

How is Ambulance Patient Care and Response Time Data Collected and Reported in Malaysia and Indonesia?

“…This background of a changing ALS/BLS environment comes with increasing clinical evidence against the use of pre-hospital advanced life support interventions when in close proximity to a tertiary health care facility for both trauma patients (5) and medical patients (6)(7)(8). It is partly for this reason that it is recommended developing countries focus on providing BLS services (9).…”