Patients Referred to a Norwegian Trauma Centre: effect of transfer distance on injury patterns, use of resources and outcomes
Type
Peer reviewed; Journal articlePeer reviewed
publishedVersion
Date
2011-06-16Author
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Background: Triage and interhospital transfer are central to trauma systems. Few studies have addressed
transferred trauma patients. This study investigated transfers of variable distances to OUH (Oslo University Hospital,
Ullevål), one of the largest trauma centres in Europe.
Methods: Patients included in the OUH trauma registry from 2001 to 2008 were included in the study.
Demographic, injury, management and outcome data were abstracted. Patients were grouped according to
transfer distance: ≤20 km, 21-100 km and > 100 km.
Results: Of the 7.353 included patients, 5.803 were admitted directly, and 1.550 were transferred. The number of
transfers per year increased, and there was no reduction in injury severity during the study period. Seventy-six per
cent of the transferred patients were severely injured. With greater transfer distances, injury severity increased, and
there were larger proportions of traffic injuries, polytrauma and hypotensive patients. With shorter distances,
patients were older, and head injuries and injuries after falls were more common. The shorter transfers less often
activated the trauma team: ≤20 km -34%; 21-100 km -51%; > 100 km -61%, compared to 92% of all directly
admitted patients. The mortality for all transferred patients was 11%, but was unequally distributed according to
transfer distance.
Conclusion: This study shows heterogeneous characteristics and high injury severity among interhospital transfers.
The rate of trauma team assessment was low and should be further examined. The mortality differences should be
interpreted with caution as patients were in different phases of management. The descriptive characteristics
outlined may be employed in the development of triage protocols and transfer guidelines.
Citation
Journal of Trauma Management & Outcomes 2011, 5:9Publisher
BioMed CentralCollections
Copyright 2011 Kristiansen et al; licensee BioMed Central Ltd.