Presence of a pre-hospital critical care team is associated with improved mortality amongst trauma patients: a national trauma registry data study
INTRODUCTION
Traumatic injuries result in considerable morbidity and mortality. Early access to critical care procedures such as rapid sequence intubation improves outcomes for trauma patients. Delivery of these interventions at the scene of an incident by a pre-hospital critical care team (PHCCT) allows earlier access to these interventions. Previous work has shown improved outcomes for trauma patients when attended to by a PHCCT. We wished to look at outcomes for trauma patients across a whole national network.
Secondary analysis of data from a routinely collected national trauma registry, covering the period from 2011 to 2016. All patients meeting trauma registry inclusion criteria were included in the study. Data was collected on demographic variables. the primary outcome was true 30 day mortality. A generalised additive model was constructed to adjust for potential confounding variables.
There were a total of 14,280 incidents with complete data. The mean age of the study group was 54.7 with 57.5% male gender. The median Injury Severity Score (ISS) was 9 with 21.5% of patients having ISS>15, and 17.8% having a severe head injury (Abbreviated Injury Score >2). The odds ratio for 30 day mortality for the group attended by a pre-hospital critical care team was 0.56 (95% CI 0.36 to 0.86, p=0.010).
Our data shows that attendance of a pre-hospital critical care team is associated with reduced mortality amongst a national cohort of trauma patients.
