Survival benefit of direct transport to trauma centers among patients with unintentional injuries in Korea: a propensity score-matched analysis

Abstract

Objective This study investigated the characteristics and survival rates of patients with unintentional severe trauma who visited a regional trauma center (TC) or a non-TC. Methods This retrospective, national, population-based, observational, case-control study included patients with abnormal Revised Trauma Score from January 2018 to December 2018. We divided hospitals into two types, TC and non-TC, and compared several variables, including in-hospital mortality. Propensity score matching was used to reduce the effect of confounding variables that influence survival outcome variables. Results Of the 25,743 patients, 5,796 visited a TC and 19,947 visited a non-TC. Compared to patients treated at non-TCs, patients treated at TCs were more likely to have a higher Injury Severity Score (TC, 11.5; non-TC, 7.4; P<0.001), higher rate of surgery or transcatheter arterial embo-lization (TC, 39.2%; non-TC, 17.6%; P< 0.001), and higher admission rate (TC, 64.7%; non-TC, 36.9%; P< 0.001) through the emergency department. After propensity score matching, 2,800 patients from both groups were analyzed. Patients in the TC had a higher survival rate than patients that were not treated in the TC (TC, 83.0%; non-TC, 78.6%; P=0.003). Conclusion This study using Korean emergency medical services data showed that initial transport to trauma centers was associated with mortality reduction. Further research is required be-cause of limitations with use of single-year data and retrospective design.