Details:

Alternative Title:
Ann Emerg Med
Personal Author:
Band, Roger A. ; Salhi, Rama A. ; Holena, Daniel N. ; Powell, Elizabeth ; Branas, Charles C. ; ... More +
Band, Roger A. ; Salhi, Rama A. ; Holena, Daniel N. ; Powell, Elizabeth ; Branas, Charles C. ; Carr, Brendan G. Less -
Description:
Study objective

Two decades ago, Philadelphia began allowing police transport of patients with penetrating trauma. We conduct a large, multiyear, citywide analysis of this policy. We examine the association between mode of out-of-hospital transport (police department versus emergency medical services [EMS]) and mortality among patients with penetrating trauma in Philadelphia.

Methods

This is a retrospective cohort study of trauma registry data. Patients who sustained any proximal penetrating trauma and presented to any Level I or II trauma center in Philadelphia between January 1, 2003, and December 31, 2007, were included. Analyses were conducted with logistic regression models and were adjusted for injury severity with the Trauma and Injury Severity Score and for case mix with a modified Charlson index.

Results

Four thousand one hundred twenty-two subjects were identified. Overall mortality was 27.4%. In unadjusted analyses, patients transported by police were more likely to die than patients transported by ambulance (29.8% versus 26.5%; OR 1.18; 95% confidence interval [CI] 1.00 to 1.39). In adjusted models, no significant difference was observed in overall mortality between the police department and EMS groups (odds ratio [OR] 0.78; 95% CI 0.61 to 1.01). In subgroup analysis, patients with severe injury (Injury Severity Score >15) (OR 0.73; 95% CI 0.59 to 0.90), patients with gunshot wounds (OR 0.70; 95% CI 0.53 to 0.94), and patients with stab wounds (OR 0.19; 95% CI 0.08 to 0.45) were more likely to survive if transported by police.

Conclusion

We found no significant overall difference in adjusted mortality between patients transported by the police department compared with EMS but found increased adjusted survival among 3 key subgroups of patients transported by police. This practice may augment traditional care.


Subject:
[+]
Adult
Article
Female
Humans
Injury Severity Score
Male
Philadelphia
Police
Retrospective Studies
Transportation Of Patients
Trauma Centers
Wounds, Gunshot
Wounds, Penetrating
Wounds, Stab

Source:
Ann Emerg Med. 63(5):608-614.e3.
Pubmed ID:
24387925
Pubmed Central ID:
PMC5912155
Document Type:
Journal Article
Funding:
R01 CE001615/CE/NCIPC CDC HHS/United States ; K08 HS017960/HS/AHRQ HHS/United States ; K08HS017960/HS/AHRQ HHS/United States ; K12 HL109009/HL/NHLBI NIH HHS/United States ; R01 AA016187/AA/NIAAA NIH HHS/United States
R01 CE001615/CE/NCIPC CDC HHS/United States ; K08 HS017960/HS/AHRQ HHS/United States ; K08HS017960/HS/AHRQ HHS/United States ; K12 HL109009/HL/NHLBI NIH HHS/United States ; R01 AA016187/AA/NIAAA NIH HHS/United States Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:51e4255c65c367f6b7727263b19595ee6e824974e604136cfd4235f238027d83
File Type:

Supporting Files

• 	NIHMS959631-supplement-supplement_1.pdf	pdf
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  	nihms959631f1.gif	gif
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