The forgotten trauma patient

Outcomes for injured patients evaluated by emergency medical services but not transported to the hospital

Kristan Staudenmayer, Renee Hsia, Ewen Wang, Karl Sporer, David Ghilarducci, David Spain, Robert MacKersie, John Sherck, Richard Kline, Craig Newgard

Research output: Contribution to journalArticle

4 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)594-600
Number of pages7
JournalJournal of Trauma and Acute Care Surgery
Volume72
Issue number3
DOIs
StatePublished - Mar 2012

Fingerprint

Emergency Medical Services
Wounds and Injuries
Ambulances
Registries
Mortality
Hospital Emergency Service
Death Certificates
Triage
Trauma Centers
Population
Cohort Studies
Retrospective Studies
Costs and Cost Analysis

Keywords

  • Outcomes assessment
  • Quality of health care
  • Traumatic brain injury

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine
  • Surgery
  • Medicine(all)

Cite this

The forgotten trauma patient : Outcomes for injured patients evaluated by emergency medical services but not transported to the hospital. / Staudenmayer, Kristan; Hsia, Renee; Wang, Ewen; Sporer, Karl; Ghilarducci, David; Spain, David; MacKersie, Robert; Sherck, John; Kline, Richard; Newgard, Craig.

In: Journal of Trauma and Acute Care Surgery, Vol. 72, No. 3, 03.2012, p. 594-600.

Research output: Contribution to journalArticle

Staudenmayer, Kristan ; Hsia, Renee ; Wang, Ewen ; Sporer, Karl ; Ghilarducci, David ; Spain, David ; MacKersie, Robert ; Sherck, John ; Kline, Richard ; Newgard, Craig. / The forgotten trauma patient : Outcomes for injured patients evaluated by emergency medical services but not transported to the hospital. In: Journal of Trauma and Acute Care Surgery. 2012 ; Vol. 72, No. 3. pp. 594-600.
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