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Review
. 2023 Oct;226(4):542-547.
doi: 10.1016/j.amjsurg.2023.06.033. Epub 2023 Jun 29.

The effect of transport mode on mortality following isolated penetrating torso Trauma

Kathryn Atkins  1 , Andrew Schneider  1 , Jared Gallaher  1 , Anthony Charles  2
Affiliations
Review

The effect of transport mode on mortality following isolated penetrating torso Trauma

Kathryn Atkins et al. Am J Surg. 2023 Oct.

Abstract

Background: Prehospital interventions may increase the time to definitive care. Compared to ground ambulance, we hypothesize improved mortality for patients with isolated, penetrating torso injuries transported via private vehicle.

Methods: We reviewed the National Trauma Data Bank (2017-2021) for adults with isolated, penetrating torso injuries stratified by mechanism (stabbing vs. firearm) and transport mode (private vehicle vs. ground ambulance). We performed a multivariable logistic regression to estimate the effect of transport mode on mortality.

Results: 48,444 patients met our inclusion criteria. Patients transported by ambulance, injured by stabbing (n = 26,633) and by firearm (n = 21,811) had adjusted odds ratios of 1.81 (95%CI 1.05-3.14, p = 0.03) and 1.66 (95%CI 1.32-2.09,p < 0.001) respectively for mortality compared to private vehicle transport.

Conclusion: Patients with penetrating torso injuries have nearly twice the odds of mortality when transported by ground ambulance than private vehicles, despite injury severity. The "scoop and run" strategy may confer a survival benefit in this population.

Keywords: Emergency medical services and trauma; Ground ambulance transport; Penetrating torso trauma; Private vehicle transport.

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Conflict of interest statement

Declaration of competing interest The authors whose names are listed immediately below certify that they have NO affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Figures

Figure 1.
Figure 1.
PRISMA Flow Diagram of Study Selection Process NTDB: National Trauma Data Bank; ED: Emergency department
Figure 2.
Figure 2.
Predicted probabilities of in-hospital mortality comparing mode of transport across Injury Severity Score (ISS), stratified by mechanism of penetrating injury
See this image and copyright information in PMC

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