Hostname: page-component-78c5997874-mlc7c Total loading time: 0 Render date: 2024-11-18T03:20:23.107Z Has data issue: false hasContentIssue false
  • English
  • Français

Prehospital Care and In-hospital Mortality of Trauma Patients in Iran

Published online by Cambridge University Press:  08 September 2014

Mohammad Paravar ,
Mehrdad Hosseinpour ,
Mahdi Mohammadzadeh Open the ORCID record for Mahdi Mohammadzadeh [Opens in a new window]  and
Azade Sadat Mirzadeh
Mohammad Paravar
Affiliation:
Trauma Research Center, Kashan University of Medical Sciences, Kashan, IRIran
Mehrdad Hosseinpour*
Affiliation:
Trauma Research Center, Kashan University of Medical Sciences, Kashan, IRIran
Mahdi Mohammadzadeh
Affiliation:
Trauma Research Center, Kashan University of Medical Sciences, Kashan, IRIran
Azade Sadat Mirzadeh
Affiliation:
Trauma Research Center, Kashan University of Medical Sciences, Kashan, IRIran
*
Correspondence: Mehrdad Hosseinpour, MD Trauma Research Center, Shahid Beheshti Hospital Kashan University of Medical Sciences Kashan, IR Iran E-mail Meh_hosseinpour@yahoo.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction

The aim of this study was to determine the effect of prehospital time and advanced trauma life support interventions for trauma patients transported to an Iranian Trauma Center.

Methods

This study was a retrospective study of trauma victims presenting to a trauma center in central Iran by Emergency Medical Services (EMS) and hospitalized more than 24 hours. Demographic and injury characteristics were obtained, including accident location, damaged organs, injury mechanism, injury severity score, prehospital times (response, scene, and transport), interventions and in-hospital outcome.

Results

Two thousand patients were studied with an average age of 36.3 (SD = 20.8) years; 83.1% were male. One hundred twenty patients (6.1%) died during hospitalization. The mean response time, at scene time and transport time were 6.6 (SD = 3), 11.1 (SD = 5.2) and 12.8 (SD = 9.4), respectively. There was a significant association of longer transport time to worse outcome (P = .02). There was a trend for patients with transport times >10 minutes to die (OR: 0.8; 95% CI, 0.1-6.59). Advanced Life Support (ALS) interventions were applied for patients with severe injuries (Revised Trauma Score ⩽7) and ALS intervention was associated with more time on scene. There was a positive association of survival with ALS interventions applied in suburban areas (P = .001).

Conclusion

In-hospital trauma mortality was more common for patients with severe injuries and long prehospital transport times. While more severely injured patients received ALS interventions and died, these interventions were associated with positive survival trends when conducted in suburban and out-of-city road locations with long transport times.

HosseinpourM, ParavarM, MohammadzadehM, MirzadehAS. Prehospital Care and In-hospital Mortality of Trauma Patients in Iran. Prehosp Disaster Med. 2014;29(5):1-5.

Keywords

emergency medicinemortalityprehospital care
Type
Original Research
Information
Prehospital and Disaster Medicine , Volume 29 , Issue 5 , October 2014 , pp. 473 - 477
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Wisborg, T, Montshiva, TR, Mock, C. Trauma research in low- and middle-income countries is urgently needed to strengthen the chain of survival. Scandinavian J Trauma Resus Emerg Med. 2011;19:62.Google Scholar
2.Naghavi, M, Abolhassani, F, Pourmalek, F, et al. The burden of disease and injury in Iran in the year 2003. Iran J Epidemiol. 2008;4(1):1-19.Google Scholar
3.Naghavi, M, Jafari, N. Mortality and morbidity profile in 29 provinces of lean in the year 2004, book 5. Ministry of Health and Medical Education. 2007;286.Google Scholar
4.Modaghegh, MH, Roudsari, BS, Sajadehchi, A. Prehospital trauma care in Tehran: potential areas for improvement. Prehosp Emerg Care. 2002;6(2):218-223.Google Scholar
5.Roudsari, BS, Nathens, AB, Arreola-Risa, C, et al. Emergency Medical Service (EMS) systems in developed and developing countries. Injury. 2007;38(9):1001-1013.Google Scholar
6.Demetriades, D, Kimbrell, B, Salim, A, et al. Trauma deaths in a mature urban trauma system: is ‘‘trimodal’’ distribution a valid concept? J Am Coll Surg. 2005;201(3):343-348.Google Scholar
7.Sasser, S, Varghese, M, Kellermann, A, Lormand, JD. Prehospital trauma care systems. Geneva: World Health Organisation, 2005.Google Scholar
8.Fazel, MR, Fakharian, E, Mahdian, M, Mohammadzadeh, M, Salehfard, L, Ramezani, M. Demographic Profiles of Adult Trauma during a 5 Year Period (2007-2011) in Kashan, IR Iran. Arch Trauma Res. 2012;1(2):63-66.Google Scholar
9.Naghavi, M, Jaafari, N, Alaeddini, F, et al. Epidemiologic study of external causes of injury in Islamic Republic of Iran, Ministry of Health, Treatment and Medical Education. Tehran, Iran: Barg-E-Rezvan Co, 2003. (in Persian).Google Scholar
10.World Health Organization. Developing prehospital trauma care approach for South-East Asia. Inter-country consultation, Ahmedabad, India. New Delhi: Regional Office for South-East Asia; July 2-4, 2003.Google Scholar
11.American College of Surgeons. Advanced Trauma Life Support for Doctors, 8th ed.Chicago (Ill): American College of Surgeons; 2008.Google Scholar
12.Bøtker, MT, Bakke, SA, Christensen, EF. A systematic review of controlled studies: do physicians increase survival with prehospital treatment. Scandinavian J Trauma Resus Emerg Med. 2009;17:12.CrossRefGoogle ScholarPubMed
13. NAEMT, McSwain N, Salomone J. PHTLS Textbook for Course Student. 7th ed. Atlanta, GA, USA: Mosby/JEMS; 2010: 236.Google Scholar
14.Ringburg, AN, Spanjersberg, WR, Frankema, SP, et al. Helicopter emergency medical services (HEMS): impact on on-scene times. J Trauma. 2007;63(2):258-262.Google Scholar
15.Carr, BG, Caplan, JM, Pryor, JP, et al. A meta-analysis of prehospital care times for trauma. Prehosp Emerg Care. 2006;10:198-206.Google Scholar
16.Carr, BG, Brachet, T, David, G, et al. The time cost of prehospital intubation and intravenous access in trauma patients. Prehosp Emerg Care. 2008;12(3):327-332.CrossRefGoogle ScholarPubMed
17.Newgard, C, Schmicker, RH, Hedges, JR. Emergency Medical Services intervals and survival in trauma: assessment of the “Golden Hour” in a North American prospective cohort. Ann Emerg Med. 2003;55(3):236-246.Google Scholar
18.Sloan, EP, Callahan, EP, Duda, J, et al. The effect of urban trauma system hospital bypass on prehospital transport times and level 1 trauma patient survival. Ann Emerg Med. 1989;18(11):1146-1150.Google Scholar
19.Stiell, IG, Nesbitt, LP, Pickett, W, et al. The OPALS Major Trauma Study: impact of advanced life-support on survival and morbidity. CMAJ. 2008;17(8):1141-1152.Google Scholar