Association between prehospital time and outcome of trauma patients in 4 Asian countries: A cross-national, multicenter cohort study

• DOI: 10.1371/journal.pmed.1003360
• Publication Date: 2020-10-06T17:22:45Z
• Authors: Chi-Hsin Chen; Sang Do Shin; Jen-Tang Sun; Sabariah Faizah J...; Hideharu Tanaka; Kyoung Jun Song; Kentaro Kajino; Akio Kimura; Edward Pei-Chuan ...; Ming-Ju Hsieh; Matthew Huei-Ming Ma; Wen-Chu Chiang
• Keywords: Quartile; Interquartile range

Background Whether rapid transportation can benefit patients with trauma remains controversial. We determined the association between prehospital time and outcome to explore concept of "golden hour" for injured patients. Methods findings conducted a retrospective cohort study transported from scene hospitals by emergency medical service (EMS) January 1, 2016, November 30, 2018, using data Pan-Asia Trauma Outcomes Study (PATOS) database. Prehospital intervals were categorized into response (RT), hospital (SH), total (TPT). The outcomes 30-day mortality functional status at discharge. Multivariable logistic regression was used investigate adjust factors including age, sex, mechanism type injury, Injury Severity Score (ISS), Revised (RTS), interventions. Overall, 24,365 4 countries (645 Japan, 16,476 Korea, 5,358 Malaysia, 1,886 Taiwan) included in analysis. Among patients, median age 45 years (lower quartile [Q1]–upper [Q3]: 25–62), 15,498 (63.6%) male. Median (Q1–Q3) RT, SH, TPT 20 (Q1–Q3: 12–39), 21 16–29), 47 32–60) minutes, respectively. In all, 280 (1.1%) died within 30 days after injury. not associated mortality. adjusted odds ratios (aORs) per 10 minutes 0.99 (95% CI 0.92–1.06, p = 0.740), 1.08 1.00–1.17, 0.065), 1.03 0.98–1.09, 0.236), However, long detrimental survival. aORs 10-minute delay 1.06 1.04–1.08, < 0.001), 1.05 1.01–1.08, 0.007), key limitation our is missing inherent design. Another major aggregate nature different unaccounted confounders such as in-hospital management. Conclusions Longer an increased risk mortality, but it may be poor This finding supports during care studied.