Is Total Out-of-hospital Time a Significant Predictor of Trauma Patient Mortality?

Lerner, E. Brooke; Billittier, Anthony J.; Dorn, Joan M.; Wu, Yow-Wu B.

doi:10.1111/j.1553-2712.2003.tb00650.x

Cited by 65 publications

(49 citation statements)

References 14 publications

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“…The time factor would appear to be subordinate in terms of pre-hospital treatment of severe trauma patients. This finding is in accordance with Lerner's study, which found that after correction for ISS, patient characteristics and treatment aspects, there was no relation between the time from the moment of the accident to the patient's arrival at hospital on the one hand and the risk of death on the other [25]. The conclusions of Lerner's study and our own should, however, be interpreted with some caution.…”

Section: Discussionsupporting

confidence: 91%

Predictors of Death in Trauma Patients who are Alive on Arrival at Hospital

Lichtveld¹,

Panhuizen

Smit³

et al. 2007

Eur J Trauma Emerg Surg

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Objective: To determine which factors predict death occurring in trauma patients who are alive on arrival at hospital Design Prospective cohort study Method Data were collected from 507 trauma patients with multiple injuries, with a Hospital Trauma Index-Injury Severity Score of 16 or more, who were initially delivered by the Emergency Medical Services to the Emergency Department of the University Medical Centre Utrecht (UMCU) during the period 1999-2000. Results: Univariate analysis showed that every year of age increase resulted in a 2% greater risk of death. If the patient had been intubated at the scene of the accident, this risk was increased 4.3-fold. Every point of increase in the Triage Revised Trauma Score (T-RTS) reduced the risk of death by 30%. A similar (but inverse) tendency was found for the HTI-ISS score, with every point of increase resulting in a 5% greater risk of death. There was a clear relationship between the base excess (BE) and hemoglobin (Hb) levels and the risk of death, the latter being increased by 8% for each mmol/l drop in BE, and reduced by 22% for each mmol/l increase in Hb. The risk of death occurring was 2.6 times higher in cases with isolated neurotrauma. These associations hardly changed in the multivariate analysis; only the relation with having been intubated at the scene disappeared. Conclusion: The risk of severely injured accident patients dying after arriving in hospital is mainly determined by the T-RTS, age, presence of isolated neurological damage, BE and Hb level. Skull/brain damage and hemorrhage appear to be the most important causes of death in the first 24 h after the accident. The time interval between the accident and arrival at the hospital does not appear to affect the risk of death.

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Section: Discussionsupporting

confidence: 91%

Predictors of Death in Trauma Patients who are Alive on Arrival at Hospital

Lichtveld¹,

Panhuizen

Smit³

et al. 2007

Eur J Trauma Emerg Surg

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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

117

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“…Moreover, the possibility of early therapy may be related to the common concept in many trauma centers referred as the "golden hour," suggesting that very early interventions are critical to save lives after injury (71). This concept has been challenged by several clinical studies (72)(73)(74). However, the information gathered from our studies, as well as the capacity to predict mortality very early after CLP, may pose an experimental model to test the hypothesis that initial interventions during the "golden hour(s)" may improve survival in trauma and critically ill patients.…”

Section: Discussionmentioning

confidence: 99%

Period of Irreversible Therapeutic Intervention during Sepsis Correlates with Phase of Innate Immune Dysfunction

Cauvi

Song

Vázquez

et al. 2012

Journal of Biological Chemistry

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Background: Sepsis is a major health problem that can be investigated in experimental animal models. Results: Its etiology is divided into an early therapeutically reversible phase displaying a robust inflammatory response followed by a late therapeutically irreversible stage with reduced innate immune response. Conclusion: Mortality is associated with a late immune dysfunction. Significance: This study provides information for the potential window for treatment.

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Is Total Out-of-hospital Time a Significant Predictor of Trauma Patient Mortality?

Abstract: Provider-assigned CUPS status, patient age, Injury Severity Score, and Revised Trauma Score all were significant predictors of trauma patient mortality. Total out-of-hospital time was not associated with mortality.

Cited by 65 publications

References 14 publications

Predictors of Death in Trauma Patients who are Alive on Arrival at Hospital

Predictors of Death in Trauma Patients who are Alive on Arrival at Hospital

Rural risk: Geographic disparities in trauma mortality

Period of Irreversible Therapeutic Intervention during Sepsis Correlates with Phase of Innate Immune Dysfunction

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