TRAUMA PATIENT OUTCOME AFTER THE PREHOSPITAL TRAUMA LIFE-SUPPORT PROGRAM

Background: We have previously demonstrated a significant improvement in trauma patient outcome after the Advanced Trauma Life Support (ATLS ) program in Trinidad and Tobago. In January of 1992, a Prehospital Tr auma Life Support (PHTLS) program was also instituted. This study asse ssed trauma patient outcome after the PHTLS program. Methods: Morbidit y (length of stay and degree of disability), mortality, injury severit y score, mechanism of injury, age, and sex among all adult trauma pati ents transported by ambulance to the major trauma hospital were assess ed between July of 1990 to December of 1991 (pre-PHTLS, n = 332) and J anuary of 1994 to June of 1995 (post-PHTLS, n = 350). Results: Age, se x distribution, percentage blunt injury, and injury severity score wer e similar for both groups. Mortality pre-PHTLS (15.7%) was greater tha n post-PHTLS (10.6%), Length of stay and disability were statistically significantly decreased post-PHTLS. Age, injury severity score, and m echanism of injury were positively correlated with mortality in both p eriods. The previously reported post-ATLS mortality was similar to the pre-PHTLS mortality. Conclusions: Post-PHTLS mortality and morbidity were significantly decreased, suggesting a positive impact of the PHTL S program on trauma patient outcome.