Delays in transfer of elderly less-injured trauma patients can have deadly consequences

Peter Fischer, Paul D. Colavita, Gregory P. Fleming, Toan T. Huynh, A. Britton Christmas, Ronald F. Sing

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Transfer of severely injured patients to regional trauma centers is often expedited; however, transfer of less-injured, older patients may not evoke the same urgency. We examined referring hospitals' length of stay (LOS) and compared the subsequent outcomes in less-injured transfer patients (TP) with patients presenting directly (DP) to the trauma center. We reviewed the medical records of less-injured (Injury Severity Score [ISS] 9 or less), older (age older than 60 years) patients transferred to a regional Level 1 trauma center to determine the referring facility LOS, demographics, and injury information. Outcomes of the TP were then compared with similarly injured DP using local trauma registry data. In 2011, there were 1657 transfers; the referring facility LOS averaged greater than 3 hours. In the less-injured patients (ISS 9 or less), the average referring facility LOS was 3 hours 20 minutes compared with 2 hours 24 minutes in more severely injured patients (ISS 25 or greater, P < 0.05). The mortality was significantly lower in the DP patients (5.8% TP vs 2.6% DP, P = 0.035). Delays in transfer of less-injured, older trauma patients can result in poor outcomes including increased mortality. Geographic challenges do not allow for every patient to be transported directly to a trauma center. As a result, we propose further outreach efforts to identify potential causes for delay and to promote compliance with regional referral guidelines.

Original languageEnglish (US)
Pages (from-to)1132-1135
Number of pages4
JournalAmerican Surgeon
Volume80
Issue number11
StatePublished - Nov 1 2014
Externally publishedYes

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Wounds and Injuries
Trauma Centers
Length of Stay
Patient Transfer
Injury Severity Score
Mortality
Medical Records
Registries
Referral and Consultation
Demography
Guidelines

All Science Journal Classification (ASJC) codes

  • Surgery
  • Medicine(all)

Cite this

Fischer, P., Colavita, P. D., Fleming, G. P., Huynh, T. T., Christmas, A. B., & Sing, R. F. (2014). Delays in transfer of elderly less-injured trauma patients can have deadly consequences. American Surgeon, 80(11), 1132-1135.

Delays in transfer of elderly less-injured trauma patients can have deadly consequences. / Fischer, Peter; Colavita, Paul D.; Fleming, Gregory P.; Huynh, Toan T.; Christmas, A. Britton; Sing, Ronald F.

In: American Surgeon, Vol. 80, No. 11, 01.11.2014, p. 1132-1135.

Research output: Contribution to journalArticle

Fischer, P, Colavita, PD, Fleming, GP, Huynh, TT, Christmas, AB & Sing, RF 2014, 'Delays in transfer of elderly less-injured trauma patients can have deadly consequences', American Surgeon, vol. 80, no. 11, pp. 1132-1135.
Fischer P, Colavita PD, Fleming GP, Huynh TT, Christmas AB, Sing RF. Delays in transfer of elderly less-injured trauma patients can have deadly consequences. American Surgeon. 2014 Nov 1;80(11):1132-1135.
Fischer, Peter ; Colavita, Paul D. ; Fleming, Gregory P. ; Huynh, Toan T. ; Christmas, A. Britton ; Sing, Ronald F. / Delays in transfer of elderly less-injured trauma patients can have deadly consequences. In: American Surgeon. 2014 ; Vol. 80, No. 11. pp. 1132-1135.
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