Effect of trauma life support training on patient outcomes: a systematic review and meta-analysis

Trauma causes significant global burden of disease. Trauma life support training programmes aim to improve early trauma care, but little is known about their effects on patient outcomes.

We conducted a systematic review using keywords and medical subject headings (MeSH-terms) related to trauma life support training in seven online databases: Medline, Embase, Cochrane, Web of Science, Global Health, CINAHL and Google Scholar. The reference lists of included articles were also searched for relevant studies. Published studies that compared patient outcomes between providers trained in any trauma life support training programme with those trained in another training programme or those not trained were included. We appraised the quality of the included studies and conducted meta-analyses using random effects models.

We screened 9,626 records from which we identified and included 19 eligible studies. There were 92,614 patients cumulatively across the 19 studies and Advanced Trauma Life Support (ATLS) was the most common trauma life support training programme. Seventeen of the studies were included in a meta-analysis with mortality as the outcome. Trauma life support training programmes were associated with reduced mortality at an odds ratio of 0.60 (95% CI 0.48-0.75). The total heterogeneity (I²) was 74.4% and the publication bias for the Egger's regression test was p = 0.2, and the Rank correlation test p = 0.90.

Trauma life support training programmes are associated with reduced mortality in trauma patients, but the evidence is observational. Future research should therefore focus on the effects of these training programmes on patient outcomes using randomised controlled or high-quality quasi-experimental designs.