Survival benefit of direct transport to trauma centers among patients with unintentional injuries in Korea: a propensity score-matched analysis

Abstract

Objective: This study investigated the characteristics and survival rates of patients with unintentional severe trauma who visited a regional trauma center (TC) or a non-TC.Methods: This retrospective, national, population-based, observational, case-control study included patients with abnormal Revised Trauma Score from January 2018 to December 2018. We divided hospitals into two types, TC and non-TC, and compared several variables including in-hospital mortality. Propensity score matching was used to eliminate the effect of confounding variables that influence survival outcome variables.Results: Of the 25,743 patients, 5,796 visited a TC and 19,947 visited a non-TC. Compared to patients treated at non-TCs, patients treated at TCs were more likely to have a higher Injury Severity Score (TC, 11.5; non-TC, 7.4; P<0.001), higher rate of surgery or transcatheter arterial embolization (TC, 39.2%; non-TC, 17.6%; P<0.001), and higher admission rate (TC, 64.7%; non-TC, 36.9%; P<0.001) through the emergency department. After propensity score matching, 2,800 patients from both groups were analyzed. Patients in the TC had a higher survival rate than patients that were not treated in the TC (TC, 83.0%; non-TC, 78.6%; P=0.003). Conclusion:This study using Korean emergency medical services data showed that initial transport to trauma centers might be effective for mortality reduction. Further research is required because of limitations with use of single-year data and retrospective design.

Intentionally self-injured patients have lower mortality when treated at trauma centers versus non-trauma centers in South Korea

“…PSM was conducted by re-sampling in the present study to control for factors influencing survival rates. Unlike studies on unintentional injuries, 31 TC patients showed higher survival rates than non-TC patients in terms of survival after hospital admission and final survival rate after ED arrival. Although patients with intentional trauma injuries have a higher severity of injuries compared with patients with intentional trauma, 29 30 TC treatment may lead to quicker transfer to the operating room and BAE, resulting in shorter ED stays and higher survival rates.…”

The Association Between Inter-Hospital Transfers and the Prognosis of Pediatric Injury in the Emergency Department

“…3 4 5 Korea’s trauma system is currently in the stage of construction, starting with the designation of regional trauma centers in 2012. The introduction of a regional trauma center reduced the mortality rate, 6 7 8 but the transfer rate between hospitals increased. 7 Regional trauma centers remain in operation, but there is no transport protocol for trauma patients in prehospital and hospital stage.…”