Js. Young et al., INTERHOSPITAL VERSUS DIRECT SCENE TRANSFER OF MAJOR TRAUMA PATIENTS IN A RURAL TRAUMA SYSTEM, The American surgeon, 64(1), 1998, pp. 88-91
The purpose of organized trauma systems is to ensure the expeditious t
ransfer of seriously injured patients to the facility best equipped to
care for their injuries. Patients are referred to our trauma center,
either by ambulance or helicopter, directly from the scene or through
interhospital transfer. We examined the difference in outcome between
those patients sent directly to the trauma center versus those seen at
other hospitals and subsequently referred to the trauma center. Our h
ypothesis was that a delay at the referring hospital is detrimental to
patient outcome. Adult trauma patients with Injury Severity Scores >1
5, treated over 16 months from July 1, 1994, to October 31, 1995, were
studied. Patients who survived 24 hours experienced significantly sho
rter intensive care unit (14 vs 10 days; P < 0.05) and hospital (21 vs
16 days; P < 0.05) lengths of stay when taken directly to the trauma
center. In addition, there were significantly fewer deaths in patients
with a probability of survival >0.5 and a slightly lower overall mort
ality in those patients who survived at least 1 day. This study demons
trates that patients with major trauma taken directly to the trauma ce
nter had shorter hospital and intensive care unit stays and lower mort
ality. The study supports the paradigm that, when possible, major trau
ma patients should be sent to trauma centers directly from the injury
scene.