Interhospital transfer of blunt multiply injured patients to a level 1 trauma center does not adversely affect outcome

Adrian T. Billeter, Frank B. Miller, Brian G. Harbrecht, Wanda Bowen, Matthew J. Stephens, Gregory C. Postel, Jason W. Smith, Matthew Penta, Royce Coleman, Glen A. Franklin, Donald D. Trunkey, Hiram C. Polk

    Research output: Contribution to journalArticle

    16 Scopus citations

    Abstract

    Background Stops at nontrauma centers for severely injured patients are thought to increase deaths and costs, potentially because of unnecessary imaging and indecisive/delayed care of traumatic brain injuries (TBIs). Methods We studied 754 consecutive blunt trauma patients with an Injury Severity Score greater than 20 with an emphasis on 212 patients who received care at other sites en route to our level 1 trauma center. Results Referred patients were older, more often women, and had more severe TBI (all P <.05). After correction for age, sex, and injury pattern, there was no difference in the type of TBI, Glasgow Coma Scale (GCS) upon arrival at the trauma center, or overall mortality between referred and directly admitted patients. GCS at the outside institution did not influence promptness of transfer. Conclusions Interhospital transfer does not affect the outcome of blunt trauma patients. However, the unnecessarily prolonged stay of low GCS patients in hospitals lacking neurosurgical care is inappropriate.

    Original languageEnglish (US)
    Pages (from-to)459-466
    Number of pages8
    JournalAmerican journal of surgery
    Volume207
    Issue number4
    DOIs
    StatePublished - Apr 2014

    Keywords

    • Head injuries
    • Imaging
    • Interhospital transfer
    • Referral
    • Trauma
    • Traumatic brain injury

    ASJC Scopus subject areas

    • Surgery

    Fingerprint Dive into the research topics of 'Interhospital transfer of blunt multiply injured patients to a level 1 trauma center does not adversely affect outcome'. Together they form a unique fingerprint.

  • Cite this

    Billeter, A. T., Miller, F. B., Harbrecht, B. G., Bowen, W., Stephens, M. J., Postel, G. C., Smith, J. W., Penta, M., Coleman, R., Franklin, G. A., Trunkey, D. D., & Polk, H. C. (2014). Interhospital transfer of blunt multiply injured patients to a level 1 trauma center does not adversely affect outcome. American journal of surgery, 207(4), 459-466. https://doi.org/10.1016/j.amjsurg.2013.04.015