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Int. J. Environ. Res. Public Health 2016, 13(2), 236; doi:10.3390/ijerph13020236

Characteristics and Outcomes of Patients Injured in Road Traffic Crashes and Transported by Emergency Medical Services

1
Department of Trauma Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
2
Department of Neurosurgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
3
Department of Plastic and Reconstructive Surgery, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Academic Editor: Jason K. Levy
Received: 9 November 2015 / Revised: 16 February 2016 / Accepted: 16 February 2016 / Published: 19 February 2016
View Full-Text   |   Download PDF [281 KB, uploaded 19 February 2016]

Abstract

To investigate the injury characteristics and mortality of patients transported by emergency medical services (EMS) and hospitalized for trauma following a road traffic crash, data obtained from the Trauma Registry System were retrospectively reviewed for trauma admissions between 1 January 2009 and 31 December 2013 in a Level I trauma center. Of 16,548 registered patients, 3978 and 1440 patients injured in road traffic crashes were transported to the emergency department by EMS and non-EMS, respectively. Patients transported by EMS had lower Glasgow coma scale (GCS) scores and worse hemodynamic measures. Compared to patients transported by non-EMS, more patients transported by EMS required procedures (intubation, chest tube insertion, and blood transfusion) at the emergency department. They also sustained a higher injury severity, as measured by the injury severity score (ISS) and the new injury severity score (NISS). Lastly, in-hospital mortality was higher among the EMS than the non-EMS group (1.8% vs. 0.3%, respectively; p < 0.001). However, we found no statistically significant difference in the adjusted odds ratio (AOR) for mortality among patients transported by EMS after adjustment for ISS (AOR 4.9, 95% CI 0.33–2.26), indicating that the higher incidence of mortality was likely attributed to the patients’ higher injury severity. In addition, after propensity score matching, logistic regression of 58 well-matched pairs did not show a significant influence of transportation by EMS on mortality (OR: 0.578, 95% CI: 0.132–2.541 p = 0.468). View Full-Text
Keywords: emergency medical services (EMS); injury severity score (ISS); mortality emergency medical services (EMS); injury severity score (ISS); mortality
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Huang, C.-Y.; Rau, C.-S.; Chuang, J.-F.; Kuo, P.-J.; Hsu, S.-Y.; Chen, Y.-C.; Hsieh, H.-Y.; Hsieh, C.-H. Characteristics and Outcomes of Patients Injured in Road Traffic Crashes and Transported by Emergency Medical Services. Int. J. Environ. Res. Public Health 2016, 13, 236.

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