Outcomes in austere trauma care: An analysis of patients transferred from scene compared to inter-hospital transfers

Rapid access to surgical care has demonstrated a survival benefit in trauma. We sought to describe a state's trauma system with a single Level one trauma center.

All available trauma encounters from 2015 to 2023 were classified as direct from scene and transfer cohorts. To mitigate survival bias, only patients with >0 days in the trauma registry were selected for analysis.

A total of 20,221 met inclusion criteria, 14,564 were classified as direct and 5658 as transfers. Blunt injury was 79.5% in direct and 84.7% in transfers (p <.001). Injury severity score was similar. In the multivariate logistic regression analysis on the matched cohort, transfer patients were less likely to experience mortality. In transfer patients, Kaplan-Meier curves showed 30-day mortality benefit.

With only a single Level one trauma center in the state, mortality was lower in transferred patients than in those brought directly from the scene.