JAMA Surgery | Original Investigation | September 20, 2017
Association of Prehospital Mode of Transport With Mortality in Penetrating Trauma
A Trauma System-Level Assessment of Private Vehicle Transportation vs. Ground Emergency Medical Services
Michael W. Wandling, MD, MS
Avery B. Nathens, MD, PhD
Michael B. Shapiro, MD
Elliott R. Haut, MD, PhD
The Question – Does ground emergency medical services transport confer a survival advantage vs. private vehicle transport for patients with penetrating injuries?
The Findings – In this cohort study of 103,029 patients, individuals transported by private vehicle were significantly less likely to die that similarly injured patients transported by ground emergency medical services, even when controlling for injury severity.
What Does This Mean? – Ground emergency medical services transport is not associated with improved survival compared with private vehicle transport among patients with penetrating injuries in urban trauma systems, suggesting prehospital trauma care may have a limited role in this subset of patients.
Comments – Following risk adjustment, individuals with penetrating injuries transported by private vehicle were less likely to die than patients transported by ground EMS (odds ratio [OR], 0.38; 95% CI, 0.31-0.47).