Abstract
To investigate the injury characteristics and mortality of patients transported by emergency medical services (EMS) and hospitalized for trauma following a road traffic crash, data obtained from the Trauma Registry System were retrospectively reviewed for trauma admissions between 1 January 2009 and 31 December 2013 in a Level I trauma center. Of 16,548 registered patients, 3978 and 1440 patients injured in road traffic crashes were transported to the emergency department by EMS and non-EMS, respectively. Patients transported by EMS had lower Glasgow coma scale (GCS) scores and worse hemodynamic measures. Compared to patients transported by non-EMS, more patients transported by EMS required procedures (intubation, chest tube insertion, and blood transfusion) at the emergency department. They also sustained a higher injury severity, as measured by the injury severity score (ISS) and the new injury severity score (NISS). Lastly, in-hospital mortality was higher among the EMS than the non-EMS group (1.8% vs. 0.3%, respectively; p < 0.001). However, we found no statistically significant difference in the adjusted odds ratio (AOR) for mortality among patients transported by EMS after adjustment for ISS (AOR 4.9, 95% CI 0.33–2.26), indicating that the higher incidence of mortality was likely attributed to the patients’ higher injury severity. In addition, after propensity score matching, logistic regression of 58 well-matched pairs did not show a significant influence of transportation by EMS on mortality (OR: 0.578, 95% CI: 0.132–2.541 p = 0.468).
Highlights
Emergency medical services (EMS) are responsible for transporting victims of motor vehicle accidents to local emergency departments
The mean ages of the 3978 patients transported by emergency medical services (EMS) and 1440 by non-EMS following a road traffic crash were 44.1 ̆ 19.3 and 43.6 ̆ 20.1 years, respectively (Table 1)
There were significantly more motorcyclists among patients transported by EMS than among those transported by non-EMS (p < 0.001)
Summary
Emergency medical services (EMS) are responsible for transporting victims of motor vehicle accidents to local emergency departments. Burt et al reported that approximately 82% of injured patients were brought to emergency departments and trauma centers by means other than the ambulance [1]. Another study reported that only close to 10% of injured patients arrived at trauma centers by private vehicle [2]. Res. Public Health 2016, 13, 236; doi:10.3390/ijerph13020236 www.mdpi.com/journal/ijerph
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