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Prehospital trauma systems reduce mortality in developing countries: a systematic review and meta-analysis
Jaymie Ang Henry1, Arthur Lawrence Reingold
1Division of Epidemiology, University of California, School of Public Health, Berkeley, CA, USA. jaymie.henry@gmail.com
The Journal of Trauma and Acute Care Surgery
|June 30, 2012
Summary
Prehospital trauma systems significantly reduce trauma mortality in developing countries by 25%. These systems are crucial for improving survival rates, especially in middle-income nations.
Area of Science:
- Public Health
- Emergency Medicine
- Global Health
Background:
- Most trauma deaths in developing nations occur pre-hospital.
- Preliminary studies suggested prehospital trauma systems improve outcomes.
- Empirical data on the overall benefit of these systems were lacking.
Purpose of the Study:
- To systematically review and meta-analyze the effectiveness of prehospital trauma systems in developing countries.
- To assess the impact of these systems on trauma mortality and prehospital response times.
Main Methods:
- Systematic review and meta-analysis of studies published up to December 2010.
- Inclusion of 14 studies for qualitative analysis and 8 studies (n=5,607) for meta-analysis.
- Primary outcome: mortality; Secondary outcomes: physiologic severity score, Injury Severity Score, prehospital time. Pooled estimates using fixed effects method.
Main Results:
- Prehospital trauma systems were associated with a 25% reduced risk of trauma mortality (RR, 0.75; 95% CI, 0.66-0.85).
- No significant heterogeneity was observed across studies (χ² = 3.71, p = 0.72).
- Reduced in-field response times were noted in both rural (66 minutes) and urban (6 minutes) settings.
Conclusions:
- Prehospital trauma systems demonstrably reduce mortality in developing countries, particularly middle-income countries.
- The findings support the adoption of prehospital trauma systems at a policy level in developing nations.
- These systems are effective in improving survival rates and reducing response times for trauma patients.
