@article{ref1,
title="Effect of private versus emergency medical systems transportation in trauma patients in a mostly physician based system- a retrospective multicenter study based on the TraumaRegister DGU®",
journal="Scandinavian journal of trauma, resuscitation and emergency medicine",
year="2016",
author="Huber, Stephan and Crönlein, Moritz and von Matthey, Francesca and Hanschen, Marc and Seidl, Fritz and Kirchhoff, Chlodwig and Biberthaler, Peter and Lefering, Rolf and Huber-Wagner, Stefan",
volume="24",
number="1",
pages="e60-e60",
abstract="BACKGROUND: The effects of private transportation (PT) to definitive trauma care in comparison to transportation using Emergency Medical Services (EMS) have so far been addressed by a few studies, with some of them finding a beneficial effect on survival. The aim of the current study was to investigate epidemiology, pre- and in-hospital times as well as outcomes in patients after PT as compared to EMS recorded in the TraumaRegister DGU®. <br><br>METHODS: All patients in the database of the TraumaRegister DGU® (TR-DGU) from participating European trauma centers treated in 2009 to 2013 with available data on the mode of transportation, ISS ≥ 4 and ICU treatment were included in the study. Epidemiological data, pre- and in-hospital times were analysed. Outcomes were analysed after adjustment for RISC-II scores. <br><br>RESULTS: 76,512 patients were included in the study, of which 1,085 (1.4 %) were private transports. Distribution of ages and trauma mechanisms showed a markedly different pattern following PT, with more children < 15 years treated following PT (3.3 % EMS vs. 9.6 for PT) and more elderly patients of 65 years or older (26.6 vs 32.4 %). Private transportation to trauma care was by far more frequent in Level 2 and 3 hospitals (41.2 % in EMS group vs 73.7 %). Median pre-hospital times were also reduced following PT (59 min for EMS vs. 46 for PT). In-hospital time in the trauma room (66 for EMS vs. 103 min for PT) and time to diagnostics were prolonged following PT. Outcome analysis after adjustment for RISC-II scores showed a survival benefit of PT over EMS transport (SMR for EMS 1.07 95 % CI 1.05-1.09; for PT 0.85 95 % CI 0.62-1.08). <br><br>DISCUSSION: The current study shows a distinct pattern concerning epidemiology and mechanism of injury following PT. PT accelerates the median pre-hospital times, but prolongs time to diagnostic measures and time in the trauma room. <br><br>CONCLUSIONS: In this distinct collective, PT seemed to lead to a small benefit in terms of mortality, which may reflect pre-hospital times, pre-hospital interventions or other confounders.<p /> <p>Language: en</p>",
language="en",
issn="1757-7241",
doi="10.1186/s13049-016-0252-1",
url="http://dx.doi.org/10.1186/s13049-016-0252-1"
}