Citation

Brown JB. JAMA Surg. 2022; ePub(ePub): ePub.

Copyright

(Copyright © 2022, American Medical Association)

DOI

10.1001/jamasurg.2022.3684

PMID

36001329

Abstract

Trauma is a time-sensitive condition. Nowhere is this more apparent than firearm violence, an epidemic occurring in our communities every day. These patients frequently need rapid operative intervention to stop life-threatening hemorrhage and shock. This has led to a scoop-and-run approach for prehospital care to minimize time to reach a trauma center.

Byrne and colleagues1 examine the association between geospatial access to trauma care and firearm-injury mortality in Philadelphia, Pennsylvania. The authors measure geospatial access as transport time from the incident location to the nearest trauma center. They use a geographic information system to calculate driving time along road networks accounting for traffic, a more robust approach than the "as the crow flies" straight-line distance.2 Rather than medical records or trauma registry data, the authors used the Philadelphia Police Department's Shooting Victim Database. As expected from this group, a robust statistical approach was used. The authors1 showed each minute of transport time was associated with an increase in mortality, with 23% of firearm fatalities attributed to transport times longer than 1 minute.

Language: en