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Geospatial Analysis of Prehospital Triage and Early Potential Preventable Traumatic Deaths
Garrett N Klutts1, Kyle J Kalkwarf1, Yijiong Yang2
1Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
The American Surgeon
|February 21, 2023
Summary
Prehospital triage is vital for trauma survival. This study found that proximity to non-trauma centers, not trauma severity, often leads to under-triage of preventable deaths in severely injured patients.
Area of Science:
- Emergency Medicine
- Trauma Surgery
- Public Health
Background:
- Prompt prehospital triage is critical for survival in severely injured patients.
- Under-triage of preventable traumatic deaths remains a significant concern in emergency medical services.
Purpose of the Study:
- To investigate the factors contributing to the under-triage of potentially preventable traumatic deaths.
- To analyze the geospatial relationship between injury location and hospital destination.
Main Methods:
- Retrospective review of 1848 trauma deaths within 24 hours in Harris County, TX.
- Identification of 186 preventable or potentially preventable (P/PP) deaths.
- Geospatial analysis correlating death locations with receiving hospitals.
Main Results:
- P/PP deaths were more frequent in males, minorities, and those with penetrating injuries.
- 36% of patients transported for P/PP deaths went to Level III, IV, or non-designated hospitals.
- Geospatial analysis indicated proximity to nearest hospitals as a key factor in under-triage.
Conclusions:
- Under-triage of trauma patients is influenced by hospital proximity rather than solely injury severity.
- Current prehospital triage protocols may need revision to prioritize definitive trauma care access.
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