An analysis of police transport in an Eastern Association for the Surgery of Trauma multicenter trial examining prehospital procedures in penetrating trauma patients

Sharven Taghavi, Zoe Maher, Amy J. Goldberg, Elliott R. Haut, Shariq Raza, Grace Chang, Leah C. Tatebe, Eman Toraih, Michelle Mendiola, Christofer Anderson, Scott Ninokawa, Patrick Maluso, Jane Keating, Sigrid Burruss, Matthew Reeves, Lauren E. Coleman, David V. Shatz, Anna Goldenberg-Sandau, Apoorva Bhupathi, M. Chance SpaldingAimee Lariccia, Emily Bird, Matthew R. Noorbakhsh, James Babowice, Marsha C. Nelson, Lewis E. Jacobson, Jamie Williams, Michael Vella, Kate Dellonte, Thomas Z. Hayward, Emma Holler, Mark J. Lieser, John D. Berne, Dalier R. Mederos, Reza Askari, Barbara Okafor, Eric Etchill, Raymond Fang, Samantha L. Roche, Laura Whittenburg, Andrew C. Bernard, James M. Haan, Kelly L. Lightwine, Scott H. Norwood, Jason Murry, Mark A. Gamber, Matthew M. Carrick, Nikolay Bugaev, Antony Tatar, Danielle Tatum

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

BACKGROUND Police transport (PT) of penetrating trauma patients in urban locations has become routine in certain metropolitan areas; however, whether it results in improved outcomes over prehospital Advanced life support (ALS) transport has not been determined in a multicenter study. We hypothesized that PT would not result in improved outcomes. METHODS This was a multicenter, prospective, observational study of adults (18+ years) with penetrating trauma to the torso and/or proximal extremity presenting at 25 urban trauma centers. Police transport and ALS patients were allocated via nearest neighbor, propensity matching. Transport mode also examined by Cox regression. RESULTS Of 1,618 total patients, 294 (18.2%) had PT and 1,324 (81.8%) were by ALS. After matching, 588 (294/cohort) remained. The patients were primarily Black (n = 497, 84.5%), males (n = 525, 89.3%, injured by gunshot wound (n = 494, 84.0%) with 34.5% (n = 203) having Injury Severity Score of 16 or higher. Overall mortality by propensity matching was not different between cohorts (15.6% ALS vs. 15.0% PT, p = 0.82). In severely injured patients (Injury Severity Score ≥16), mortality did not differ between PT and ALS transport (38.8% vs. 36.0%, respectively; p = 0.68). Cox regression analysis controlled for relevant factors revealed no association with a mortality benefit in patients transported by ALS. CONCLUSION Police transport of penetrating trauma patients in urban locations results in similar outcomes compared with ALS. Immediate transport to definitive trauma care should be emphasized in this patient population. LEVEL OF EVIDENCE Prognostic and Epidemiologic; Level III.

Original languageEnglish
Pages (from-to)265-272
Number of pages8
JournalJournal of Trauma and Acute Care Surgery
Volume93
Issue number2
DOIs
StatePublished - Aug 1 2022

Bibliographical note

Funding Information:
E.R.H. reports research funding from The Patient-Centered Outcomes Research Institute (PCORI), the Agency for Healthcare Research and Quality (AHRQ), the NIH/NHLBI, the DOD/Army Medical Research Acquisition Activity, and the Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF). E.R.H. receives royalties from Lippincott, Williams, Wilkins for a book—“Avoiding Common ICU Errors.” E.R.H. was a paid speaker for the Vizient Hospital Improvement Innovation Network (HIIN) VTE Prevention Acceleration Network.

Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • Penetrating trauma
  • emergency medical services
  • mortality
  • outcomes
  • police transport

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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