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Original research
Oh Hyun Kim
Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Republic of Korea.
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8415-0318
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: Al though controversial, there has been a consensus that compared with non-regional trauma centers, regional trauma centers have survival benefits. In a predominantly rural province with a single regional trauma center, we compared the in-hospital mortality of all trauma patients and severely injured patients between regional and non-regional trauma centers.
Methods: Using data extracted from the National Emergency Department Information System in Korea, we examined all trauma patients who visited emergency departments in Gangwon province between January 2015 and December 2017. The International Classification of Disease-Based Injury Severity Score (ICISS) was used to categorize the severity of the patients. Propensity score matching was used for balancing the severity between the two groups.
Results: Of 23,510 trauma patients, 2,857 and 20,653 were treated in regional and non-regional trauma centers, respectively. After propensity score matching, all patients in the non-regional trauma center group had a 6.27-fold higher risk of mortality than those in the regional trauma center group; severely injured patients—defined as those with ICISS < 0.9—in the non-regional trauma center group had a 4.90-fold higher risk of mortality than those in the regional trauma center group. ICISS cutoff values for mortality were 0.9015 and 0.8737 for the non-regional and regional trauma center groups, respectively.
Conclusion: Conventional paradigms of trauma systems can be used in predominantly rural Korean provinces, because trauma care in regional trauma centers conferred better survival benefits than that in non-regional trauma centers. Additionally, severely injured patients should be transported to regional trauma centers from the trauma scene.
Keywords
Trauma systems, Trauma centers, Injury, Patient, Outcome, Mortality
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Original research
Oh Hyun Kim
Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Ilsan-ro 20, Wonju 26426, Republic of Korea.
Corresponding Author
ORCiD: https://orcid.org/0000-0002-8415-0318
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 08 Sep, 2020
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Critical Care & Emergency Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Al though controversial, there has been a consensus that compared with non-regional trauma centers, regional trauma centers have survival benefits. In a predominantly rural province with a single regional trauma center, we compared the in-hospital mortality of all trauma patients and severely injured patients between regional and non-regional trauma centers.
Methods: Using data extracted from the National Emergency Department Information System in Korea, we examined all trauma patients who visited emergency departments in Gangwon province between January 2015 and December 2017. The International Classification of Disease-Based Injury Severity Score (ICISS) was used to categorize the severity of the patients. Propensity score matching was used for balancing the severity between the two groups.
Results: Of 23,510 trauma patients, 2,857 and 20,653 were treated in regional and non-regional trauma centers, respectively. After propensity score matching, all patients in the non-regional trauma center group had a 6.27-fold higher risk of mortality than those in the regional trauma center group; severely injured patients—defined as those with ICISS < 0.9—in the non-regional trauma center group had a 4.90-fold higher risk of mortality than those in the regional trauma center group. ICISS cutoff values for mortality were 0.9015 and 0.8737 for the non-regional and regional trauma center groups, respectively.
Conclusion: Conventional paradigms of trauma systems can be used in predominantly rural Korean provinces, because trauma care in regional trauma centers conferred better survival benefits than that in non-regional trauma centers. Additionally, severely injured patients should be transported to regional trauma centers from the trauma scene.
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
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