Injury-adjusted Mortality of Patients Transported by Police Following Penetrating Trauma

Band, Roger A.; Pryor, John P.; Gaieski, David F.; Dickinson, Edward T.; Cummings, D. G.; Carr, Brendan G.

doi:10.1111/j.1553-2712.2010.00948.x

Cited by 34 publications

(36 citation statements)

References 37 publications

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“…We previously described the relationship between mode of transport and outcomes in a single urban trauma center in which we found no overall mortality difference between groups and identified a trend toward decreased mortality for severely injured patients and patients with gunshot wounds who were transported by police. 22 The current study focuses on the population of an entire city, and although we still found no difference in mortality overall, we found decreased adjusted mortality in key subgroups.…”

Section: Discussioncontrasting

confidence: 63%

“…Patients included in a previously published single-center analysis were among those included in this population-based multicenter study. 22 Subjects who were transported by private vehicle or arrived to the emergency department (ED) by other means were excluded from the analysis because they were thought to represent a diverse and distinct subset of patients. 24 Subjects transferred into or out of trauma centers were excluded because initial transport or final outcomes could not be appropriately assessed.…”

Section: Methodsmentioning

confidence: 99%

“…Given our concern that we may be faced with reporting a negative study, we were careful to make sure that our sample size would be adequate to detect an effect if it existed. We used standard assumptions about α (.05); previous information from our data, including baseline police department and EMS mortality rates (21.4% and 14.8%, respectively) 22 ; a sample size ratio of EMS to police department (2.7); and a target power of 90% to calculate a target sample size of 1,906 patients.…”

Section: Methodsmentioning

confidence: 99%

“…In that study, we found no difference in adjusted mortality between patients transported by police compared with ambulance. 22 We have now broadened this analysis to include all patients with penetrating injury who were treated at any of Philadelphia’s 8 Level I and II adult trauma centers between 2003 and 2007.…”

Section: Introductionmentioning

confidence: 99%

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Severity-Adjusted Mortality in Trauma Patients Transported by Police

Band

Salhi

Holena

et al. 2014

Annals of Emergency Medicine

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Study objective Two decades ago, Philadelphia began allowing police transport of patients with penetrating trauma. We conduct a large, multiyear, citywide analysis of this policy. We examine the association between mode of out-of-hospital transport (police department versus emergency medical services [EMS]) and mortality among patients with penetrating trauma in Philadelphia. Methods This is a retrospective cohort study of trauma registry data. Patients who sustained any proximal penetrating trauma and presented to any Level I or II trauma center in Philadelphia between January 1, 2003, and December 31, 2007, were included. Analyses were conducted with logistic regression models and were adjusted for injury severity with the Trauma and Injury Severity Score and for case mix with a modified Charlson index. Results Four thousand one hundred twenty-two subjects were identified. Overall mortality was 27.4%. In unadjusted analyses, patients transported by police were more likely to die than patients transported by ambulance (29.8% versus 26.5%; OR 1.18; 95% confidence interval [CI] 1.00 to 1.39). In adjusted models, no significant difference was observed in overall mortality between the police department and EMS groups (odds ratio [OR] 0.78; 95% CI 0.61 to 1.01). In subgroup analysis, patients with severe injury (Injury Severity Score >15) (OR 0.73; 95% CI 0.59 to 0.90), patients with gunshot wounds (OR 0.70; 95% CI 0.53 to 0.94), and patients with stab wounds (OR 0.19; 95% CI 0.08 to 0.45) were more likely to survive if transported by police. Conclusion We found no significant overall difference in adjusted mortality between patients transported by the police department compared with EMS but found increased adjusted survival among 3 key subgroups of patients transported by police. This practice may augment traditional care.

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Section: Discussioncontrasting

confidence: 63%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Severity-Adjusted Mortality in Trauma Patients Transported by Police

Band

Salhi

Holena

et al. 2014

Annals of Emergency Medicine

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“…In the several articles focused on evaluation of police hospital transport in Philadelphia and a few additional municipalities, the authors suggested that it is at least as effective as transport via EMS ambulances. It may, in fact, be life‐saving because of the greater presence of police vehicles on patrol and the often faster response times of law enforcement to shooting incidents (Band et al., ; Band et al., ; Branas et al., ; Wandling et al., ).…”

Section: Resultsmentioning

confidence: 99%

Rapid response to mass shootings

Reeping

Jacoby

Rajan

et al. 2019

Criminology & Public Policy

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Research Summary:We conducted a scoping review of literature indexed in the National Library of Medicine's journal citation database, MEDLINE, and Scopus to identify articles in which the rapid response of hospital staff, emergency medical services personnel, the police, and the public to mass shootings is covered. Sixty-five articles were included, and critical themes related to reducing the harm from a mass shooting were summarized.Policy Implications: According to our findings, when mass shootings occur in the United States, several evidenceinformed steps can be taken from the moment the first bullet is fired until the last injured individual is transported to the hospital to promote a rapid response that can reduce death and disability. Ten recommendations are made ranging from recognition of the need for rapid response and bystander training to triage and transport training of police and avoidance of over-response.

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Undertriage of Firearm-Related Injuries in a Major Metropolitan Area

2017

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Undertriage of firearm-related injuries was much more prevalent than expected. Although the likelihood of dying during hospitalization was greater among patients treated in designated trauma centers, these patients were substantially in worse condition across all measures of injury severity. A smaller proportion of patients treated in designated trauma centers died during the first 24 hours of hospitalization. This study highlights the need for better regional coordination, especially with interhospital transfers, as well as the importance of assessing the distribution of emergency medical services resources to make the trauma care system more effective and equitable.

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Injury-adjusted Mortality of Patients Transported by Police Following Penetrating Trauma

Abstract: Background: More than a decade ago, the city of Philadelphia began allowing police transport of penetrating trauma patients.

Cited by 34 publications

References 37 publications

Severity-Adjusted Mortality in Trauma Patients Transported by Police

Severity-Adjusted Mortality in Trauma Patients Transported by Police

Rapid response to mass shootings

Undertriage of Firearm-Related Injuries in a Major Metropolitan Area

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