Prehospital times and outcomes for hypotensive trauma patients in Sweden

The influence of EMS transport time on trauma patient survival has previously been examined. Studies have shown conflicting results, and some studies have been unable to prove any association between prehospital times and outcomes for trauma patients. In the context of Swedish trauma systems, the impact of prehospital time remains unclear.

The aim of the present study was to investigate the correlation between prehospital time and outcomes for hypotensive trauma patients in Sweden.

A total of 3,740 hypotensive trauma patients treated during the years 2013-2022 were identified through the Swedish Trauma Registry (SweTrau). The study included both ground ambulance patients and helicopter emergency medical services patients. A binary logistic regression model was used to analyse the correlation between total prehospital time and mortality while controlling for confounding factors. The primary study endpoint of this study was 30-day mortality after the initial traumatic event.

After adjusting for potentially confounding factors, including RTS, NISS, patient age, sex, and methods of injury, a longer total prehospital time was found to be associated with increased odds of mortality in the study population. In the present study, a one-minute increase in total prehospital time was found to have an adjusted odds ratio (AOR) of 1.005 for mortality (95% CI 1.000-1.009; P = 0.046) for undifferentiated hypotensive trauma patients.

In this nationwide study aimed at investigating the correlation between prehospital time and survival among hypotensive trauma patients in Sweden, a longer total prehospital time was found to be associated with increased odds of mortality for undifferentiated hypotensive trauma patients, with the odds of mortality increasing by 5.1% per 10-min increase in total prehospital time.