Κυριακή 13 Δεκεμβρίου 2020

TRAUMA PATIENT TRANSPORT TIMES UNCHANGED DESPITE TRAUMA CENTER PROLIFERATION: A 10 YEAR REVIEW

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Introduction In certain regions of the U.S. there has been a dramatic proliferation of trauma centers. The goal of our study was to evaluate transport times during this period of trauma center proliferation. Methods Aggregated data summarizing level I trauma center admissions in Arizona between 2009 and 2018 were provided to our institution by the Arizona Department of Health Services. We evaluated patient demographics, transport times and injury severity for both rural and urban injuries. Results Data included statistics summarizing 266,605 level I trauma admissions in the state of Arizona. The number of state-designated trauma centers during this time increased from 14 to 47, with level I centers increasing from 8 to 13. Slight decreases in mean ISS (rural 9.4 vs. 8.4; urban 7.9 vs 7.0) were observed over this period. Median transport time for cases transported from the injury scene directly to a level I center remained stable in urban areas at 0.9 hours in both 2009 and 2018. In rural areas, transport times for these cases were approximately double, but also stable, with median times of 1.8 and 1.9 hours. Transport times for cases requiring inter-facility transfer prior to admission at a level I center increased by 0.3 hours for urban injuries (5.3 hours to 5.6) and 0.9 hours for rural injuries (5.6 to 6.5). Conclusion Despite the 3-fold increase in the number of state-designated trauma centers, transport time has not decreased in urban or rural areas. This finding highlights the need for regulatory oversight regarding the number and geographic placement of state-designated trauma centers. Level of Evidence III The authors declare no conflicts of interest. The study was presented as a Quickshot at the 79th Annual Meeting of AAST & Clinical Congress of Acute Care Surgery held online instead of Waikoloa, Hawaii, September 9-12, 2020. Corresponding Author: Jordan A. Weinberg, MD, Division Chief, Trauma/Acute General Surgery, Trauma Administration, St. Joseph's Hospital and Medical Center, 350 W. Thomas Road, Phoenix, AZ 85013. Tel: (602) 406-3157. Email: JordanWeinberg@Creighton.edu © 2020 Lippincott Williams & Wilkins, Inc.
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