TY - JOUR
T1 - The forgotten trauma patient
T2 - Outcomes for injured patients evaluated by emergency medical services but not transported to the hospital
AU - Staudenmayer, Kristan
AU - Hsia, Renee
AU - Wang, Ewen
AU - Sporer, Karl
AU - Ghilarducci, David
AU - Spain, David
AU - MacKersie, Robert
AU - Sherck, John
AU - Kline, Richard
AU - Newgard, Craig
PY - 2012/3
Y1 - 2012/3
N2 - 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.
AB - 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.
KW - Outcomes assessment
KW - Quality of health care
KW - Traumatic brain injury
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U2 - 10.1097/TA.0b013e31824764ef
DO - 10.1097/TA.0b013e31824764ef
M3 - Article
C2 - 22491541
AN - SCOPUS:84862671384
SN - 2163-0755
VL - 72
SP - 594
EP - 600
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
IS - 3
ER -