Rural Vascular Trauma: Time to Care.

Area of Science:

• Trauma Surgery
• Vascular Surgery
• Emergency Medicine

Background:

• Rural vascular trauma research is limited, with prior studies focusing on case series from over 20 years ago.
• There is a need to understand the relationship between clinical status and time to definitive care in rural vascular trauma patients.

Purpose of the Study:

• To assess the association between clinical decline and time to care for rural vascular trauma patients.
• To identify factors influencing timely access to a trauma center for vascular injuries in rural settings.

Main Methods:

• Retrospective cohort study of adult trauma patients with vascular injury admitted to a Level II trauma center.
• Multivariable logistic regression analysis to evaluate the impact of clinical decline on arrival within the 'golden hour' (first hour of care).
• Shock Index Ratio (SIR) was used as a key indicator of clinical decline.

Main Results:

• 149 patients were included in the study.
• An increase in the Shock Index Ratio (SIR) was significantly associated with prolonged time to care.
• For every 1-unit increase in SIR, there was a 99.9% reduction in the odds of arriving at the trauma center within the golden hour.

Conclusions:

• Clinical decline, indicated by SIR, correlates with delayed time to care in rural vascular trauma.
• Findings suggest a need to optimize pre-hospital care and transport strategies in rural areas with prolonged arrival times.
• This study provides contemporary data on rural vascular trauma, addressing a gap in research from the last two decades.