TY - JOUR
T1 - Prehospital notification for major trauma patients requiring emergency hospital transport
T2 - A systematic review
AU - Synnot, Anneliese
AU - Karlsson, Adrian
AU - Brichko, Lisa
AU - Chee, Melissa
AU - Fitzgerald, Mark
AU - Misra, Mahesh C
AU - Howard, Teresa
AU - Mathew, Joseph
AU - Rotter, Thomas
AU - Fiander, Michelle
AU - Gruen, Russell L
AU - Gupta, Amit
AU - Dharap, Satish
AU - Fahey, Madonna
AU - Stephenson, Michael
AU - O'Reilly, Gerard
AU - Cameron, Peter A
AU - Mitra, Biswadev
AU - on behalf of the Australia-India Trauma Systems Collaboration (AITSC)
PY - 2017/8
Y1 - 2017/8
N2 - Objective
This systematic review aimed to determine the effect of prehospital notification systems for major trauma patients on overall (<30 days) and early (<24 hours) mortality, hospital reception, and trauma team presence (or equivalent) on arrival, time to critical interventions, and length of hospital stay.
Methods
Experimental and observational studies of prehospital notification compared with no notification or another type of notification in major trauma patients requiring emergency transport were included. Risk of bias was assessed using the Cochrane ACROBAT-NRSI tool. A narrative synthesis was conducted and evidence quality rated using the GRADE criteria.
Results
Three observational studies of 72,423 major trauma patients were included. All were conducted in high-income countries in hospitals with established trauma services, with two studies undertaking retrospective analysis of registry data. Two studies reported overall mortality, one demonstrating a reduction in mortality; (adjusted odds ratio (OR) 0.61, 95% confidence interval (CI) 0.39 to 0.94, 72,073 participants); and the other demonstrating a nonsignificant change (OR 0.61, 95% CI 0.23 to 1.64, 81 participants). The quality of this evidence was rated as very low.
Conclusion
Limited research on the topic constrains conclusive evidence on the effect of prehospital notification on patient-centered outcomes after severe trauma. Composite interventions that combine prehospital notification with effective actions on arrival to hospital such as trauma bay availability, trauma team presence, and early access to definitive management may provide more robust evidence towards benefits of early interventions
AB - Objective
This systematic review aimed to determine the effect of prehospital notification systems for major trauma patients on overall (<30 days) and early (<24 hours) mortality, hospital reception, and trauma team presence (or equivalent) on arrival, time to critical interventions, and length of hospital stay.
Methods
Experimental and observational studies of prehospital notification compared with no notification or another type of notification in major trauma patients requiring emergency transport were included. Risk of bias was assessed using the Cochrane ACROBAT-NRSI tool. A narrative synthesis was conducted and evidence quality rated using the GRADE criteria.
Results
Three observational studies of 72,423 major trauma patients were included. All were conducted in high-income countries in hospitals with established trauma services, with two studies undertaking retrospective analysis of registry data. Two studies reported overall mortality, one demonstrating a reduction in mortality; (adjusted odds ratio (OR) 0.61, 95% confidence interval (CI) 0.39 to 0.94, 72,073 participants); and the other demonstrating a nonsignificant change (OR 0.61, 95% CI 0.23 to 1.64, 81 participants). The quality of this evidence was rated as very low.
Conclusion
Limited research on the topic constrains conclusive evidence on the effect of prehospital notification on patient-centered outcomes after severe trauma. Composite interventions that combine prehospital notification with effective actions on arrival to hospital such as trauma bay availability, trauma team presence, and early access to definitive management may provide more robust evidence towards benefits of early interventions
KW - advanced trauma life support care
KW - emergency medical service communication systems
KW - prehospi-tal emergency care
KW - review
KW - systematic
KW - trauma
UR - http://www.scopus.com/inward/record.url?scp=85028530135&partnerID=8YFLogxK
U2 - 10.1111/jebm.12256
DO - 10.1111/jebm.12256
M3 - Article
C2 - 28467026
AN - SCOPUS:85028530135
VL - 10
SP - 212
EP - 221
JO - Journal of Evidence-Based Medicine
JF - Journal of Evidence-Based Medicine
SN - 1756-5383
IS - 3
ER -