Outcomes of blunt trauma patients in police versus ground ambulance transport across US trauma centers

Abstract

Aim

Blunt injuries constitute a major cause of death in the United States. Regionalization in trauma systems improves patients' survival and outcomes. Limited data exist on the impact of mode of transport in regionalized trauma systems. This study examines the association between trauma designation levels and survival to hospital discharge of patients with blunt trauma transported by police or ground ambulance.

Methods

This retrospective-matched cohort study used the 2017 National Trauma Data Bank dataset. Adult blunt trauma patients transported by police were identified and matched (one-to-four) to those transported by ground ambulance. Demographic characteristics, injury, and clinical data were described and compared according to trauma designation levels. The survival rate was determined by the transport mode and/or the trauma designation levels.

Results

A total of 5316 blunt trauma patients were included. Mean age was 41.8 (±16.5) years, and most were males (81.8%). Most patients were transported to Level I centers and were more likely to be admitted (91.1%) compared to those transported to level II and level III trauma centers (87.5%). They also had a lower survival rate compared with the latter group ((98.7%) vs. (99.7%), p = 0.001). Survival rates were similar when comparing patients by mode of transport (p = 0.785). This remained unchanged after stratifying by the trauma designation levels (p > 0.05).

Conclusions

Adult patients with blunt trauma transported by police or ground ambulance had similar survival across different trauma level centers. Increased police involvement in the transport of blunt trauma patients is recommended.