Annals of Emergency Medicine Journal Club. Is the golden hour tarnished? Registries and multivariable regression

Abstract

WHAT IS ALREADY KNOWN ON THIS TOPIC: The "golden hour" concept in trauma is pervasive despite little evidence to support it. WHAT QUESTION THIS STUDY ADDRESSED: Is there an association between various emergency medical services (EMS) intervals and in-hospital mortality in seriously injured adults? WHAT THIS STUDY ADDS TO OUR KNOWLEDGE: In 3,656 injured patients with substantial perturbations of vital signs or mental status, transported by 146 EMS agencies to 51 trauma centers across North America, no association was found among any EMS interval and mortality. HOW THIS MIGHT CHANGE CLINICAL PRACTICE: This study suggests that in our current out-of hospital and emergency care system time may be less crucial than once thought. Routine lights-and-sirens transport for trauma patients, with its inherent risks, may not be warranted.