Delayed trauma team activation: patient characteristics and outcomes

Area of Science:

• Trauma surgery
• Emergency medicine
• Public health

Background:

• Delayed trauma team activation (DTTA) is a critical concern in trauma care.
• Understanding factors contributing to DTTA is essential for improving patient outcomes.

Purpose of the Study:

• To identify factors associated with DTTA.
• To determine if DTTA impacts patient outcomes such as mortality and length of hospital stay.

Main Methods:

• Analysis of registry data from 2008-2010 at a Level II trauma center.
• DTTA defined as activation >30 minutes post-arrival with triage criteria or clinical evidence of injury.
• Statistical methods included chi-square tests, t-tests, Wilcoxon statistics, and multivariate analysis.

Main Results:

• DTTA occurred in 1.5% of 9,525 patients.
• Significant associations with DTTA included older age (>55 years), nonwhite ethnicity, blunt assault, Injury Severity Score (ISS) ≥16, Glasgow Coma Scale (GCS) score of 15, and severe head injury (MAIS3+).
• Firearm and motor vehicle injuries were less common in DTTA cases. No association found with sex, falls, stabbings, or BAC ≥80 mg/dL. Mortality did not differ, but hospital stay was longer and rehabilitation discharges were more common.

Conclusions:

• DTTA is infrequent and associated with specific patient demographics and injury types.
• Older age, nonwhite ethnicity, blunt assaults, and normal GCS scores are key predictors of DTTA.
• Increased recognition of severe head injuries (MAIS3+) in patients experiencing DTTA is warranted to improve care and outcomes.