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Clin Exp Emerg Med > Epub ahead of print
doi: https://doi.org/10.15441/ceem.22.318    [Epub ahead of print]
Survival benefit of direct transport to trauma centers among patients with unintentional injuries in Korea: a propensity score-matched analysis
Dong Jun Lee1 , Seok Hoon Ko2 , Jongkyeong Kang3 , Myung Chun Kim1 , Han Zo Choi1
1Department of Emergency Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea
2Department of Emergency Medicine, Kyung Hee University Medical Center, Seoul, Korea
3Department of Statistics, Seoul National University, Seoul, Korea
Correspondence  Han Zo Choi Email: sacehan@daum.net
Received: May 4, 2022. Revised: August 30, 2022.  Accepted: August 30, 2022. Published online: September 29, 2022.
This study investigated the characteristics and survival rates of patients with unintentional severe trauma who visited a regional trauma center (TC) or a non-TC.
This retrospective, national, population-based, observational, case-control study included patients with abnormal Revised Trauma Score from January 2018 to December 2018. We divided hospitals into two types, TC and non-TC, and compared several variables, including in-hospital mortality. Propensity score matching was used to reduce the effect of confounding variables that influence survival outcome variables.
Of the 25,743 patients, 5,796 visited a TC and 19,947 visited a non-TC. Compared to patients treated at non-TCs, patients treated at TCs were more likely to have a higher Injury Severity Score (TC, 11.5; non-TC, 7.4; P<0.001), higher rate of surgery or transcatheter arterial embolization (TC, 39.2%; non-TC, 17.6%; P<0.001), and higher admission rate (TC, 64.7%; non-TC, 36.9%; P<0.001) through the emergency department. After propensity score matching, 2,800 patients from both groups were analyzed. Patients in the TC had a higher survival rate than patients that were not treated in the TC (TC, 83.0%; non-TC, 78.6%; P=0.003).
This study using Korean emergency medical services data showed that initial transport to trauma centers was associated with mortality reduction. Further research is required because of limitations with use of single-year data and retrospective design.
Keywords: Emergency medical services; Trauma centers; Propensity score; Hospital mortality
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