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Factors Associated with Survival in Adult Trauma Patients Transported to US Trauma Centers by Police

Published online by Cambridge University Press:  03 November 2020

Jure M. Colnaric
Affiliation:
Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon University of Ljubljana, Ljubljana, Slovenia
Rana H. Bachir
Affiliation:
Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon
Mazen J. El Sayed*
Affiliation:
Department of Emergency Medicine, American University of Beirut Medical Center, Beirut, Lebanon Emergency Medical Services and Prehospital Care Program, American University of Beirut Medical Center, Beirut, Lebanon
*
Correspondence: Mazen J. El Sayed, MD, MPH, FAAEM, FAEMS, Associate Professor of Clinical Emergency Medicine, Director of EMS & Prehospital Care, Department of Emergency Medicine, American University of Beirut Medical Center, P.O. Box - 11-0236 Riad El Solh, Beirut1107 2020Lebanon, E-mail: melsayed@aub.edu.lb

Abstract

Introduction:

Police units often reach the trauma scene before Emergency Medical Services (EMS). Initiatives aiming at delivering early basic trauma care by non-medical providers including police personnel are on the rise. This study describes characteristics of trauma patients transported by police to US hospitals and identifies factors associated with survival in this patient population.

Methods:

Using the 2015 National Trauma Data Bank (NTDB), an observational study was conducted of adult trauma patients who were transported by police. After describing the study population, the factors associated with survival to hospital discharge were evaluated using a multivariate analysis.

Results:

A total of 2,394 patients were included in the study. Patients had a median age of 34.0 years (interquartile range [IQR]: 25-48) and most were males (84.5%). Blunt trauma mechanism (59.4%) was more common than penetrating trauma (29.4%). Factors associated with improved survival included: comorbidity (odds ratio [OR] = 2.92; 95% CI, 1.33-6.40); use of drugs (OR = 2.91; 95% CI, 1.07-7.92); cut/pierce (OR = 11.07; 95% CI, 2.10-58.43); motor vehicle traffic (MVT) mechanism (OR = 6.56; 95% CI, 1.60-26.98); trauma resulting in fractures (OR = 3.03; 95% CI, 1.38-6.64); and private/commercial insurance (OR = 3.41; 95% CI, 1.10-10.55).

Conclusion:

In this study population, a relatively high survival rate was noted (93.5%). Police transport of patients with blunt trauma was unexpectedly more common. Factors associated with survival to hospital discharge were identified. These factors can be used to implement more standardized and protocol-driven risk stratification tools of trauma patients on scene to improve police involvement in trauma patient transport.

Type
Original Research
Copyright
© The Author(s), 2020. Published by Cambridge University Press on behalf of the World Association for Disaster and Emergency Medicine

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