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[Rescue time and survival of severely injured patients in Germany]
C Kleber1, R Lefering, A J Kleber
1Centrum für Muskuloskeletale Chirurgie, Campus Virchow Klinikum, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin. christian.kleber@charite.de
Background:
Independent of the rescue system type, a rescue time of less than 60 min for trauma patients is usually required and considered to be crucial for the outcome. The goal of this study was to investigate the impact of the rescue time on hospital survival in severely injured patients.
Methods:
With the help of the German Trauma Registry of the DGU, the population and rescue time were systematically analyzed with regard to the survival rate. A lower mortality rate was observed with a higher injury severity in metropolitan cities compared to small towns.
Results:
A multivariate regression analysis revealed no clinically relevant impact of the rescue time length in the German rescue system on survival. This can be explained by a higher amount of preclinical medical procedures during longer rescue times.
Conclusions:
Within the German rescue system, the length of rescue time has no relevant impact on the survival of trauma patients admitted to a clinic. This could be explained by the higher numbers of preclinical measures and due to the limitations of a register study with selection bias. Therefore, we advocate that the necessary and suitable preclinical medical procedures be performed to stabilize the patient, even in cases that have exceeded the 60-min gold standard time window. In conclusion the "golden hour" concept today might better be interpreted as an individual and appropriate "golden period" of trauma.
