Distance to Trauma Care and Mortality

Question –  What is the association of injury incident location with mortality?

Findings – This cross-sectional study of 16 082 adults found an 8% increase in the odds of death for every 5-mile increase in distance to the nearest trauma center and an 3% increased odds of death for every 5-year increase in neighborhood median age.

Meaning – Characteristics of injury incident locations may contribute to injury mortality and should be considered when planning trauma care systems.

Jarman MP, Curriero FC, Haut ER, Pollack Porter K, Castillo RC. Associations of Distance to Trauma Care, Community Income, and Neighborhood Median Age With Rates of Injury Mortality. JAMA Surg. 2018 Feb 7. doi: 10.1001/jamasurg.2017.6133. [Epub ahead of print] PubMed PMID: 29417146.

Full Article: https://jamanetwork.com/journals/jamasurgery/fullarticle/2671392

Prehospital Transport in Penetrating Trauma

Question – Does ground EMS transport confer a survival advantage vs. private vehicle transport for patients with penetrating injuries?

Findings – In this cohort study of 103,029 patients, individuals transported by private vehicle were significantly less likely to die than similarly injured patients transported by ground emergency medical services, even when controlling for injury severity (odds ratio [OR], 0.38; 95% CI, 0.31-0.47).

Meaning – Ground emergency medical services transport is not associated with improved survival compared with private vehicle transport among patients with penetrating injuries in urban trauma systems, suggesting prehospital trauma care may have a limited role in this subset of patients.

Wandling MW, Nathens AB, Shapiro MB, Haut ER. Association of Prehospital Mode of Transport With Mortality in Penetrating Trauma: A Trauma System-Level Assessment of Private Vehicle Transportation vs Ground Emergency Medical Services. JAMA Surg. 2017 Sep 20. doi: 10.1001/jamasurg.2017.3601. [Epub ahead of print] PubMed PMID: 28975247.

Full Article: https://jamanetwork.com/journals/jamasurgery/fullarticle/2654239