Effects of distance and rescue time to medical facilities on traffic mortality utilizing GIS

Int J Inj Contr Saf Promot. 2018 Sep;25(3):329-335. doi: 10.1080/17457300.2018.1431931. Epub 2018 Feb 20.

Abstract

Although supported by little scientific evidence, the concept of 'golden hour,' which claims that mortality for trauma patients rises significantly over rescue time, plays a vital role in the design of our current trauma system. Only the contrary results could be found by using Fatality Analysis Reporting System data from 2010 to 2012. The results of logistic regression showed that longer total time intervals were associated with lower traffic mortality, with an odds ratio (OR) of 0.993 per minute. Utilizing the closest facility solver in the Geographic Information System, the effect of 'reverse causation' and the difference between trauma centre and non-trauma centre on the time-mortality relationship were discussed. Furthermore, based on the Kentucky Collision Analysis for the Public data from 2010 to 2012, the results of logistic regression showed that the mortality increased with each additional mile to the trauma centre with an OR of 1.011 per mile.

Keywords: Golden hour; geographical information systems; logistic regression analysis; rescue time.

MeSH terms

  • Accidents, Traffic / mortality*
  • Geographic Information Systems*
  • Health Services Accessibility*
  • Humans
  • Kentucky / epidemiology
  • Logistic Models
  • Time Factors
  • Trauma Centers*
  • Wounds and Injuries / mortality