Impact of on-Site Care, Prehospital Time, and Level of in-Hospital Care on Survival in Severely Injured Patients

Sampalis, John S.; Lavoie, André; Williams, John; Mulder, David S.; Kalina, Mathias

doi:10.1097/00005373-199302000-00014

Cited by 270 publications

(193 citation statements)

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“…Time to treatment is presumed to be a significant factor in trauma outcomes, 41 and would disparately impact rural populations, 5,6 but evidence for the relationship between pre-hospital time and mortality is widely variable. 30,32,[42][43][44][45][46][47][48][49][50][51][52] Other factors, such as community-level wealth and insurance coverage, [53][54][55] may also contribute to geographic disparities in injury mortality. Further research is needed to examine the potentially complex network of factors that determine injury outcomes for rural residents.…”

Section: Discussionmentioning

confidence: 99%

Rural risk: Geographic disparities in trauma mortality

Jarman

Castillo

Carlini

et al. 2016

Surgery

113

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Section: Discussionmentioning

confidence: 99%

Rural risk: Geographic disparities in trauma mortality

Jarman

Castillo

Carlini

et al. 2016

Surgery

113

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“…10 Although the concept of the "golden hour" may not be supported by the evidence, 26 longer time intervals between severe injury and definitive care have been associated with a significant increase in mortality. 27 It has been estimated that 84% of all U.S. residents have access to a level I or II trauma center within one hour and about onethird of these residents have this access only if flown by helicopter. 28 There are four additional benefits of HEMS that may not be as readily apparent as shorter transport times.…”

Section: Discussionmentioning

confidence: 99%

Reduced Mortality in Injured Adults Transported by Helicopter Emergency Medical Services

Sullivent

Faul

Wald

2011

Prehospital Emergency Care

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Background. Some studies have shown improved outcomes with helicopter emergency medical services (HEMS) transport, while others have not. Safety concerns and cost have prompted reevaluation of the widespread use of HEMS. Objective. To determine whether the mode of transport of trauma patients affects mortality. Methods. Data for 56,744 injured adults aged ≥18 years transported to 62 U.S. trauma centers by helicopter or ground ambulance were obtained from the National Sample Program of the 2007 National Trauma Data Bank. In-hospital mortality was calculated for different demographic and injury severity groups. Adjusted odds ratios (AOR) were produced by utilizing a logistic regression model measuring the association of mortality and type of transport, controlling for age, gender, and injury severity (Injury Severity Score [ISS] and Revised Trauma Score [RTS]). Results. The odds of death were 39% lower in those transported by HEMS compared with those transported by ground ambulance (AOR = 0.61, 95% confidence interval [CI] = 0.54-0.69). Among those aged ≥55 years, the odds of death were not significantly different (AOR = 0.92, 95% CI = 0.74-1.13). Among all transports, male patients had a higher odds of death (AOR = 1.23, 95% CI = 1.10-1.38) than female patients. The odds of death increased with each year

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“…2,[21][22][23][24][25][26] However, these studies have had very small sample sizes and did not control for key variables such as injury severity, treatment, or demographics. Other published studies have disputed the ''shorter is better'' philosophy.…”

Section: 19mentioning

confidence: 99%

The Golden Hour: Scientific Fact or Medical “Urban Legend”?

Lerner

Moscati

2001

Academic Emergency Medicine

383

220

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Abstract. The term ''golden hour'' is commonly used to characterize the urgent need for the care of trauma patients. This term implies that morbidity and mortality are affected if care is not instituted within the first hour after injury. This concept justifies much of our current trauma system. However, definitive references are generally not provided when this concept is discussed. It remains unclear whether objective data exist. This article discusses a detailed literature and historical record search for support of the ''golden hour'' concept. None is identified.

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Impact of on-Site Care, Prehospital Time, and Level of in-Hospital Care on Survival in Severely Injured Patients

Cited by 270 publications

References 0 publications

Rural risk: Geographic disparities in trauma mortality

Rural risk: Geographic disparities in trauma mortality

Reduced Mortality in Injured Adults Transported by Helicopter Emergency Medical Services

The Golden Hour: Scientific Fact or Medical “Urban Legend”?

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