Prehospital time intervals for trauma patients according to population density levels in Sweden; a national retrospective cohort study.
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| Názov: | Prehospital time intervals for trauma patients according to population density levels in Sweden; a national retrospective cohort study. |
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| Autori: | Lundberg OHM; Department of Intensive and Perioperative Care, Skåne University Hospital, Malmö, Sweden.; Department of Clinical Sciences (IKVL), Anaesthesiology and Intensive Care, Medical Faculty, Lund University, Lund, Sweden., Lapidus O; Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden., Bäckström D; Department of Biomedical and Clinical Sciences (BKV), Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden. denise.backstrom@liu.se.; Department of Leadership and Command & Control, Swedish Defence University, Karlstad, Sweden. denise.backstrom@liu.se. |
| Zdroj: | Scandinavian journal of trauma, resuscitation and emergency medicine [Scand J Trauma Resusc Emerg Med] 2025 Dec 04; Vol. 33 (1), pp. 193. Date of Electronic Publication: 2025 Dec 04. |
| Spôsob vydávania: | Journal Article |
| Jazyk: | English |
| Informácie o časopise: | Publisher: BioMed Central Country of Publication: England NLM ID: 101477511 Publication Model: Electronic Cited Medium: Internet ISSN: 1757-7241 (Electronic) Linking ISSN: 17577241 NLM ISO Abbreviation: Scand J Trauma Resusc Emerg Med Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: London : BioMed Central |
| Výrazy zo slovníka MeSH: | Emergency Medical Services*/statistics & numerical data , Wounds and Injuries*/therapy , Wounds and Injuries*/mortality , Wounds and Injuries*/epidemiology , Population Density* , Time-to-Treatment*/statistics & numerical data, Humans ; Sweden/epidemiology ; Retrospective Studies ; Male ; Female ; Middle Aged ; Registries ; Adult ; Injury Severity Score ; Time Factors ; Aged |
| Abstrakt: | Background: Minimising time from injury to hospital admission is considered a key factor in trauma. Trauma care is often centralised to hospitals, which, because of their urban location, make treatment more accessible to patients in densely populated areas. If prehospital time increases with declining population density, an effect on mortality could hence be present. The primary aim of this study was to describe prehospital time intervals across population density groups. A secondary objective was to compare the 30-day mortality rates in these population groups. Methods: This retrospective cohort study was based on the Swedish Trauma registry (SweTrau) between 2018 and 2019. Based on their home municipality, patients were divided into groups of high, medium or low population density. The time interval distributions were described and compared. Secondary outcomes were reported. A multivariate mortality analysis included time intervals, demographics, injury severity score, physiological parameters and other covariables such as care provided by a prehospital physician. Results: A total of 14,538 patients were included. The distribution across high, medium and low population concentrations was 34%, 47% and 19%, respectively. The response and transport times were significantly longer in the low population group compared with patients from groups high and medium, with a median difference of 4 and 11-15 min, respectively (p < 0.001). The median on-scene time of 20 min was shortest in the medium group with a one minute difference to both other groups (p < 0.001). The crude mortality of 5% in the low density group was significantly lower than in the other two (both 6%) (p = 0.005). However, after adjustment no association between mortality and prolonged prehospital time intervals was seen. The involvement of a prehospital physician in the care was associated with lower mortality (OR 0.60, 95% CI 0.39-0.91; p = 0.02). Conclusions: Although prehospital time intervals increased with remoteness, these differences were not associated with increased mortality. Further, residing in either high, medium or low density population areas was not consistently associated with mortality. (© 2025. The Author(s).) |
| References: | PLoS Med. 2020 Oct 6;17(10):e1003360. (PMID: 33022018) Scand J Trauma Resusc Emerg Med. 2021 Jan 6;29(1):9. (PMID: 33407748) Eur J Trauma Emerg Surg. 2018 Aug;44(4):589-596. (PMID: 28825159) Prehosp Disaster Med. 1995 Jan-Mar;10(1):24-9. (PMID: 10155402) Acad Emerg Med. 2001 Jul;8(7):758-60. (PMID: 11435197) Scand J Trauma Resusc Emerg Med. 2023 Oct 5;31(1):53. (PMID: 37798724) Prehosp Emerg Care. 2019 Jul-Aug;23(4):527-537. (PMID: 30462550) Aust N Z J Surg. 1999 Oct;69(10):697-701. (PMID: 10527344) J Trauma. 1989 May;29(5):623-9. (PMID: 2657085) Lakartidningen. 2016 Mar 22;113:. (PMID: 27003522) J Neurosurg Anesthesiol. 2017 Apr;29(2):161-167. (PMID: 26797107) Ann Emerg Med. 2010 Mar;55(3):235-246.e4. (PMID: 19783323) J Trauma. 1996 Jun;40(6):944-50. (PMID: 8656481) JAMA. 2017 Oct 24;318(16):1581-1591. (PMID: 29067429) Acad Emerg Med. 2002 Apr;9(4):288-95. (PMID: 11927452) Eur J Trauma Emerg Surg. 2023 Aug;49(4):1627-1637. (PMID: 36808554) BMC Emerg Med. 2021 Jul 6;21(1):78. (PMID: 34229629) J Trauma. 1993 Feb;34(2):252-61. (PMID: 8459466) Lancet. 2007 Oct 20;370(9596):1453-7. (PMID: 18064739) Injury. 2015 Apr;46(4):602-9. (PMID: 25627482) Scand J Trauma Resusc Emerg Med. 2009 Mar 05;17:12. (PMID: 19265550) Inj Prev. 2010 Oct;16(5):302-8. (PMID: 20595139) J Trauma Acute Care Surg. 2012 Mar;72(3):765-72. (PMID: 22491568) Surgeon. 2023 Dec;21(6):397-404. (PMID: 37652802) J Trauma Acute Care Surg. 2017 Nov;83(5):965-974. (PMID: 28590350) Int J Emerg Med. 2023 Jul 14;16(1):43. (PMID: 37452288) J Trauma Acute Care Surg. 2022 Mar 1;92(3):520-527. (PMID: 34407005) JAMA Surg. 2018 Jun 20;153(6):e180674. (PMID: 29710068) |
| Contributed Indexing: | Keywords: Emergency medical services; Mortality; On-scene time; Population density; Prehospital care; Response time; Transport time; Transportation of patients; Trauma |
| Entry Date(s): | Date Created: 20251203 Date Completed: 20251204 Latest Revision: 20251206 |
| Update Code: | 20251206 |
| PubMed Central ID: | PMC12676833 |
| DOI: | 10.1186/s13049-025-01514-z |
| PMID: | 41339901 |
| Databáza: | MEDLINE |
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Nájsť tento článok vo Web of Science | Abstrakt: | Background: Minimising time from injury to hospital admission is considered a key factor in trauma. Trauma care is often centralised to hospitals, which, because of their urban location, make treatment more accessible to patients in densely populated areas. If prehospital time increases with declining population density, an effect on mortality could hence be present. The primary aim of this study was to describe prehospital time intervals across population density groups. A secondary objective was to compare the 30-day mortality rates in these population groups.<br />Methods: This retrospective cohort study was based on the Swedish Trauma registry (SweTrau) between 2018 and 2019. Based on their home municipality, patients were divided into groups of high, medium or low population density. The time interval distributions were described and compared. Secondary outcomes were reported. A multivariate mortality analysis included time intervals, demographics, injury severity score, physiological parameters and other covariables such as care provided by a prehospital physician.<br />Results: A total of 14,538 patients were included. The distribution across high, medium and low population concentrations was 34%, 47% and 19%, respectively. The response and transport times were significantly longer in the low population group compared with patients from groups high and medium, with a median difference of 4 and 11-15 min, respectively (p < 0.001). The median on-scene time of 20 min was shortest in the medium group with a one minute difference to both other groups (p < 0.001). The crude mortality of 5% in the low density group was significantly lower than in the other two (both 6%) (p = 0.005). However, after adjustment no association between mortality and prolonged prehospital time intervals was seen. The involvement of a prehospital physician in the care was associated with lower mortality (OR 0.60, 95% CI 0.39-0.91; p = 0.02).<br />Conclusions: Although prehospital time intervals increased with remoteness, these differences were not associated with increased mortality. Further, residing in either high, medium or low density population areas was not consistently associated with mortality.<br /> (© 2025. The Author(s).) |
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| ISSN: | 1757-7241 |
| DOI: | 10.1186/s13049-025-01514-z |