Implementation of a major trauma team. Analysis of activation and care times in patients admitted to the ICU

Abstract

ObjectiveTo analyze the factors associated with the activation of the severe trauma care team (STAT) in patients admitted to the ICU, to measure its impact on care times, and to analyze the groups of patients according to activation and level of anatomical involvement. DesignProspective cohort study of severe trauma admitted to the ICU. From June 2017 to May 2019. Risk factors for the activation of the STAT analysed with logistic regression and CART type classification tree. SettingSecond level hospital ICU. PatientsPatients admitted consecutively. InterventionsNo. Main variables of interestSTAT activation. Demographic variables. Injury severity (ISS), intentionality, mechanism, assistance times, evolutionary complications, and mortality. ResultsA total of 188 patients were admitted (46.8% of STAT activation), median age of 52 (37−64) years (activated 47 (27−62) vs not activated 55 (42−67) P = 0.023), males 84.0%. No difference in mortality according to activation. The logistic model finds as factors: care (16.6 (2.1−13.2)) and prehospital intubation (4.2 (1.8−9.8)) and severe lower extremity injury (4.4 (1.6−12.3)). Accidental fall (0.2 (0.1−0.6)) makes activation less likely. The CART model selects the type of trauma mechanism and can separate high and low energy trauma. ConclusionsFactors associated with STAT activation were prehospital care, requiring prior intubation, high-energy mechanisms, and severe lower extremity injuries. Shorter care times if activated without influencing mortality. We must improve activation in older patients with low-energy trauma and without prehospital care.