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Multicenter Study
. 2022 Mar 8;12(1):4100.
doi: 10.1038/s41598-022-06933-x.

Association between prehospital fluid resuscitation with crystalloids and outcome of trauma patients in Asia by a cross-national multicenter cohort study

Chih-Wei Sung  1 , Jen-Tang Sun  2 , Edward Pei-Chuan Huang  1   3 , Sang Do Shin  4 , Kyoung Jun Song  4 , Ki Jeong Hong  4 , Sabariah Faizah Jamaluddin  5 , Do Ngoc Son  6   7   8 , Ming-Ju Hsieh  3 , Matthew Huei-Ming Ma  3   9 , Li-Min Hsu #  10 , Wen-Chu Chiang #  11   12 ; PATOS Clinical Research Network
Collaborators, Affiliations
Multicenter Study

Association between prehospital fluid resuscitation with crystalloids and outcome of trauma patients in Asia by a cross-national multicenter cohort study

Chih-Wei Sung et al. Sci Rep. .

Abstract

Prehospital fluid resuscitation with crystalloids in patients following trauma remain controversial. This study aimed to investigate the association between prehospital fluid resuscitation and outcomes of trauma patients in Asia. We conducted a retrospective cohort study of trauma patients between 2016 and 2018 using data from the Pan-Asia Trauma Outcomes Study (PATOS) database. Prehospital fluid resuscitation was defined as any administration of intravenous crystalloid fluid on the ambulance before arrival to hospitals. The outcomes were in-hospital mortality and poor functional outcomes, defined as Modified Rankin Scale ≥ 4. Propensity score matching (PSM) was used to equalize potential prognostic factors in both groups. This study included 31,735 patients from six countries in Asia, and 4318 (13.6%) patients had ever received prehospital fluid resuscitation. The patients receiving prehospital fluid resuscitation had a higher risk of in-hospital mortality, with an adjusted odds ratio (aOR) of 2.02, 95% confidence interval (CI) 1.32-3.10, p = 0.001 in PSM analysis. Prehospital fluid resuscitation was also associated with poor functional outcomes, with an OR 1.73, 95% CI: 1.48-2.03, p < 0.001 in PSM analysis. Prehospital fluid resuscitation in patients with major trauma (injury severity score ≥ 16) presented a higher risk of poor functional outcomes (aOR = 2.65, 95% CI: 1.89-3.73 in PSM analysis, pinteraction = 0.006) via subgroup analysis. Prehospital fluid resuscitation of trauma patients is associated with higher in-hospital mortality and poor functional outcomes in the subgroup in countries studied.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow diagram of the enrolled patients. Figures are made by Microsoft PowerPoint 2019 and SPSS version 26.
Figure 2
Figure 2
(a) Subgroup analysis for association between prehospital fluid resuscitation and in-hospital mortality, (b) subgroup analysis for association between prehospital fluid resuscitation and poor functional outcome. Figures are made by Microsoft PowerPoint 2019 and SPSS version 26.
See this image and copyright information in PMC

References

    1. Dadoo S, et al. Prehospital fluid administration in trauma patients: A survey of state protocols. Prehosp. Emerg. Care. 2017;21:605–609. doi: 10.1080/10903127.2017.1315202. - DOI - PubMed
    1. Kauvar DS, Lefering R, Wade CE. Impact of hemorrhage on trauma outcome: An overview of epidemiology, clinical presentations, and therapeutic considerations. J. Trauma. 2006;60:S3–11. doi: 10.1097/01.ta.0000199961.02677.19. - DOI - PubMed
    1. de Crescenzo C, Gorouhi F, Salcedo ES, Galante JM. Prehospital hypertonic fluid resuscitation for trauma patients: A systematic review and meta-analysis. J. Trauma Acute Care Surg. 2017;82:956–962. doi: 10.1097/TA.0000000000001409. - DOI - PubMed
    1. Haut ER, et al. Prehospital intravenous fluid administration is associated with higher mortality in trauma patients: A National Trauma Data Bank analysis. Ann. Surg. 2011;253:371–377. doi: 10.1097/SLA.0b013e318207c24f. - DOI - PubMed
    1. Ley EJ, et al. Emergency department crystalloid resuscitation of 1.5 L or more is associated with increased mortality in elderly and nonelderly trauma patients. J. Trauma. 2011;70:398–400. doi: 10.1097/TA.0b013e318208f99b. - DOI - PubMed

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