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

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

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.

Publication types

  • Review

MeSH terms

  • Adult
  • Ambulances
  • Emergency Medical Services*
  • Firearms*
  • Hospital Mortality
  • Humans
  • Injury Severity Score
  • Retrospective Studies
  • Trauma Centers
  • Wounds, Penetrating* / therapy