VOLUME 38 | ISSUE 1 | JANUARY-FEBRUARY 2018

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Association between the mode of transport and in-hospital medical complications in trauma patients: findings from a level-I trauma center in Saudi Arabia

Nawfal Aljerian,a Saleh Alhaidar,b Ali Alothman,c Wijdan AlJohi,c Faisal Abdullah Albaqami,d Suliman Abdullah Alghname 

From the aEmergency Medical Services, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; bCollege of Medicine, King Saud University, Riyadh, Saudi Arabia; cCollege of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia; dCollege of Medicine, Imam Mohammed University, Riyadh, Saudi Arabia; ePopulation Health, King Abdullah International Research Center, Riyadh, Saudi Arabia

How to cite this article:

Aljerian N, Alhaidar S, Alothman A, AlJohi W, Albaqami FA, Alghnam SA. Association between the mode of transport and in-hospital medical complications in trauma patients: findings from a level-I trauma center in Saudi Arabia. Ann Saudi Med 2018; 38(1): 488-494.

DOI: 10.5144/0256-4947.2018.488

Abstract

BACKGROUND: In Saudi Arabia, injury is the leading cause of death. Even if nonfatal, the impact of injuries on population health is enormous, as thousands of young patients suffer permanent disabilities every year. Unlike in developed countries, private transportation (PT) is a common means to transport trauma patients. Outcome differences between patients transported via PT relative to emergency medical services (EMS) has not been previously explored.

 

OBJECTIVES: To evaluate the association between transportation mode and in-hospital complications among trauma patients.

 

DESIGN: Retrospective.

 

SETTING: Tertiary care center.

 

PATIENTS AND METHODS: The study included all patients (≥16 years), who were admitted following trauma. 

 

MAIN OUTCOME MEASURES: The main outcome in the study was the occurrence of any medical complications including stroke, sepsis, myocardial infarction, pulmonary embolism, pneumonia, renal failure, acute respiratory distress syndrome, and cardiac arrest. 

 

RESULTS: The 493 patients were relatively young (over two-thirds of the sample were 45 years old or younger) and over half the population sustained injuries due traffic crashes. More than half (58%) of patients arrived via private transportation. Regression analyses revealed that in-hospital complications following injuries were significantly lower among those who arrived via PT. However, after incorporating propensity score matching, we found no difference in hospital complications (OR=0.55, 95% CI 0.25-1.17).

 

CONCLUSION: Multiple factors may influence this unexpected finding, such as distance to health care set.tings, the belief that PT is faster or lack of knowledge of the EMS contact number. Further efforts are needed to raise awareness of the importance of using EMS to transport trauma patients to hospitals. Prevention programs to reduce traffic crashes may facilitate reduction in traumatic injuries and associated complications.

 

LIMITATIONS: Retrospective and conducted in one center only. 

 

 

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