Multiple, simultaneous trauma patients: Are they worse off?

Area of Science:

• Trauma Surgery
• Emergency Medicine
• Healthcare Management

Background:

• Mass casualty events can strain trauma center resources.
• Simultaneous arrivals of multiple severely injured patients may impact care.
• Investigating outcomes for clustered trauma patient arrivals is crucial.

Purpose of the Study:

• To evaluate if multiple trauma patients arriving in close proximity have different outcomes.
• To compare outcomes for paired (PAIRS) and clustered (CLUSTERS) trauma arrivals versus individual arrivals (ALONE).

Main Methods:

• Retrospective review of 4,619 major trauma patients over 5.5 years.
• Categorization of patients into PAIRS (≤10 min apart), CLUSTERS (≤30 min apart), and ALONE (>4 hours apart).
• Multivariate regression analysis to assess differences in operating room admission, hospital/ICU length of stay, and mortality.

Main Results:

• PAIRS and CLUSTERS were more likely to have direct operating room admission than ALONE patients.
• No significant differences were found in intensive care unit (ICU) or hospital length of stay.
• Mortality rates did not significantly differ between groups.

Conclusions:

• Close temporal proximity of multiple trauma patients increases likelihood of immediate surgery.
• This management difference does not appear to adversely affect patient outcomes.
• Trauma centers can manage clustered arrivals effectively without compromising patient outcomes.