Abstract 372: Age-Dependent Effect of Trauma Center Transport on Survival Outcomes Among Severe Trauma Patients: Nationwide Observational Study

Abstract

Introduction: Previous studies showed that the prognosis for severe trauma patients is better after transport to trauma centers compared to non-trauma centers. However, the benefit from transport to trauma centers may differ according to age group. This study aimed to evaluate the age-dependent effect of trauma center transport on survival outcomes among severe trauma patients. Methods: A cross-sectional study using the Korean national emergency medical service (EMS) based on Severe Trauma Registry in 2018-2019 was conducted. EMS-treated trauma patients whose injury severity score was above or equal to 16, and who were not out-of-hospital cardiac arrest or death on arrival were included. Patients were classified into 3 groups: pediatrics (age <19), working age (age 19-65), and elderly (age>65). The primary outcome was in-hospital mortality. Multivariable logistic regression analysis was conducted to evaluate the effect of trauma center transport on outcome after adjusting age, sex, comorbidity, mechanism of injury, Revised Trauma Score, and Injury Severity Score. All analysis was stratified according to the age group, and subgroup analysis for traumatic brain injury was also conducted. Results: Overall, a total of 10,511 patients were included in the study, and the number of patients in each age group was 488 in pediatrics, 6,812 in working age, and 3,211 in elderly, respectively. The adjusted odds ratio (95% confidence interval [CI]) of trauma center transport on in-hospital mortality were 0.76 (95% CI, 0.43-1.32) in pediatrics, 0.78 (95% CI, 0.68-0.90) in working age, 0.71(95% CI, 0.60-0.85) in elderly, respectively. In the subgroup analysis of traumatic brain injury, the benefit from trauma center transport was observed only in elderly group. Conclusion: We found the age-dependent effect of trauma center transport in severe trauma patients. There was no beneficial effect of trauma center transport in pediatric group. Further research is warranted to evaluate and develop the response system for pediatric severe trauma patients in Korea.