Citation

Staudenmayer K, Hsia R, Wang E, Sporer K, Ghilarducci D, Spain D, Mackersie R, Sherck J, Kline R, Newgard C. J. Trauma Acute Care Surg. 2012; 72(3): 594-600.

Affiliation

Stanford, California From the Stanford University School of Medicine (K. Staudenmayer, E.W., D.S.), Stanford, California; Departments of Emergency Medicine (R.H., K.Sporer) and Surgery (R.M.), University of California San Francisco, San Francisco, California; Santa Clara County EMS (D.G.), San Jose, California; Department of Surgery (J.S.), Santa Clara Valley Medical Center, San Jose, California; Trauma Services (R.K.), Regional Medical Center, San Jose, California; Center for Policy and Research in Emergency Medicine (C.N.), Department of Emergency Medicine, Oregon Health & Science University, Portland, Oregon.

Copyright

(Copyright © 2012, Lippincott Williams and Wilkins)

DOI

10.1097/TA.0b013e31824764ef

PMID

22491541

Abstract

BACKGROUND:: Injured patients who are not transported by an ambulance to the hospital are often not included in trauma registries. The outcomes of these patients have until now been unknown. Understanding what happens to nontransports is necessary to better understand triage validity, patient outcomes, and costs associated with injury. We hypothesized that a subset of patients who were not transported from the scene would later present for evaluation and that these patients would have a nonzero mortality rate. METHODS:: This is a population-based, retrospective cohort study of injured adults and children for three counties in California from 2006 to 2008. Prehospital data for injured patients for whom an ambulance was dispatched were probabilistically linked to trauma registry data from four trauma centers, state-level discharge data, emergency department records, and death files (1-year mortality). RESULTS:: A total of 69,413 injured persons who were evaluated at the scene by emergency medical services were included in the analysis. Of them, 5,865 (8.5%) were not transported. Of those not transported, 1,616 (28%) were later seen in an emergency department and discharged and 92 (2%) were admitted. Seven (0.2%) patients later died. CONCLUSION:: Patients evaluated by emergency medical services, but not initially transported from the field after injury, often present later to the hospital. The mortality rate in this population was not zero, and these patients may represent preventable deaths. LEVEL OF EVIDENCE:: III, therapeutic study.

Language: en