TY - JOUR
T1 - National Variability in Out-of-Hospital Treatment After Traumatic Injury
AU - Bulger, Eileen M.
AU - Nathens, Avery B.
AU - Rivara, Frederick P.
AU - MacKenzie, Ellen
AU - Sabath, Daniel R.
AU - Jurkovich, Gregory J.
PY - 2007/3/1
Y1 - 2007/3/1
N2 - Study objective: The optimal out-of-hospital treatment for trauma patients remains a subject of national debate. Researchers designing future studies to address these issues must understand the variability in treatment that exists across the United States. We define the variability in the out-of-hospital treatment provided to trauma patients in the United States. Methods: This was a retrospective analysis of prospectively collected data for a cohort study of trauma outcomes. The study was conducted at 15 urban or suburban regions across the United States, 18 Level I trauma centers and 51 nontrauma centers. We used a weighted population sample based on data from all hospital trauma deaths and a sample of patients discharged between January 2001 and December 2002. Entry criteria included at least 1 body region with an Abbreviated Injury Score greater than 3 and age between 18 and 84 years. Exclusion criteria were patient age greater than 65 years and isolated hip fractures and patients with burns. Results: Complete out-of-hospital data were available for 3,357 patients, representing a weighted population sample of 9,929 patients. Out-of-hospital treatment varied substantially among the regions, including out-of-hospital intubation (5% to 48%), use of neuromuscular blocking agents or sedatives to facilitate intubation (0% to 100%), surgical airway access (0.1% to 3.5%), peripheral and central intravenous access (22% to 95%), and needle thoracentesis (0% to 5%). Conclusion: There is considerable national variability in out-of-hospital procedures performed for trauma patients.
AB - Study objective: The optimal out-of-hospital treatment for trauma patients remains a subject of national debate. Researchers designing future studies to address these issues must understand the variability in treatment that exists across the United States. We define the variability in the out-of-hospital treatment provided to trauma patients in the United States. Methods: This was a retrospective analysis of prospectively collected data for a cohort study of trauma outcomes. The study was conducted at 15 urban or suburban regions across the United States, 18 Level I trauma centers and 51 nontrauma centers. We used a weighted population sample based on data from all hospital trauma deaths and a sample of patients discharged between January 2001 and December 2002. Entry criteria included at least 1 body region with an Abbreviated Injury Score greater than 3 and age between 18 and 84 years. Exclusion criteria were patient age greater than 65 years and isolated hip fractures and patients with burns. Results: Complete out-of-hospital data were available for 3,357 patients, representing a weighted population sample of 9,929 patients. Out-of-hospital treatment varied substantially among the regions, including out-of-hospital intubation (5% to 48%), use of neuromuscular blocking agents or sedatives to facilitate intubation (0% to 100%), surgical airway access (0.1% to 3.5%), peripheral and central intravenous access (22% to 95%), and needle thoracentesis (0% to 5%). Conclusion: There is considerable national variability in out-of-hospital procedures performed for trauma patients.
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U2 - 10.1016/j.annemergmed.2006.06.038
DO - 10.1016/j.annemergmed.2006.06.038
M3 - Article
C2 - 16978737
AN - SCOPUS:33847221093
SN - 0196-0644
VL - 49
SP - 293
EP - 301
JO - Annals of emergency medicine
JF - Annals of emergency medicine
IS - 3
ER -