Rayan Jafnan Alharbi1,2, Sumina Shrestha3,4, Virginia Lewis3, Charne Miller5. 1. School of Nursing & Midwifery, La Trobe University, 1st floor, HSB 1, La Trobe University, Bundoora, VIC, 3086, Australia. Ralharbi@windowslive.com. 2. Department of Emergency Medical Service, Jazan University, Jazan, Saudi Arabia. Ralharbi@windowslive.com. 3. Australian Institute for Primary Care and Ageing, School of Nursing & Midwifery, La Trobe University, Bundoora, VIC, Australia. 4. Community Development and Environment Conservation Forum, Chautara, Nepal. 5. School of Nursing & Midwifery, La Trobe University, 1st floor, HSB 1, La Trobe University, Bundoora, VIC, 3086, Australia.
Abstract
BACKGROUND: Traumatic injury remains the leading cause of death, with more than five million deaths every year. Little is known about the comparative effectiveness in reducing mortality of trauma care systems at different stages of development. The objective of this study was to review the literature and examine differences in mortality associated with different stages of trauma system development. METHOD: A systematic review of peer-reviewed population-based studies retrieved from MEDLINE, EMBASE, and CINAHL. Additional studies were identified from references of articles, through database searching, and author lists. Articles written in English and published between 2000 and 2020 were included. Selection of studies, data extraction, and quality assessment of the included studies were performed by two independent reviewers. The results were reported as odds ratio (OR) with 95 % confidence intervals (CI). RESULTS: A total of 52 studies with a combined 1,106,431 traumatic injury patients were included for quantitative analysis. The overall mortality rate was 6.77% (n = 74,930). When patients were treated in a non-trauma centre compared to a trauma centre, the pooled statistical odds of mortality were reduced (OR 0.74 [95% CI 0.69-0.79]; p < 0.001). When patients were treated in a non-trauma system compared to a trauma system the odds of mortality rates increased (OR 1.17 [95% CI 1.10-1.24]; p < 0.001). When patients were treated in a post-implementation/initial system compared to a mature system, odds of mortality were significantly higher (OR 1.46 [95% CI 1.37-1.55]; p < 0.001). CONCLUSION: The present study highlights that the survival of traumatic injured patients varies according to the stage of trauma system development in which the patient was treated. The analysis indicates a significant reduction in mortality following the introduction of the trauma system which is further enhanced as the system matures. These results provide evidence to support efforts to, firstly, implement trauma systems in countries currently without and, secondly, to enhance existing systems by investing in system development. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42019142842 .
BACKGROUND:Traumatic injury remains the leading cause of death, with more than five million deaths every year. Little is known about the comparative effectiveness in reducing mortality of trauma care systems at different stages of development. The objective of this study was to review the literature and examine differences in mortality associated with different stages of trauma system development. METHOD: A systematic review of peer-reviewed population-based studies retrieved from MEDLINE, EMBASE, and CINAHL. Additional studies were identified from references of articles, through database searching, and author lists. Articles written in English and published between 2000 and 2020 were included. Selection of studies, data extraction, and quality assessment of the included studies were performed by two independent reviewers. The results were reported as odds ratio (OR) with 95 % confidence intervals (CI). RESULTS: A total of 52 studies with a combined 1,106,431 traumatic injurypatients were included for quantitative analysis. The overall mortality rate was 6.77% (n = 74,930). When patients were treated in a non-trauma centre compared to a trauma centre, the pooled statistical odds of mortality were reduced (OR 0.74 [95% CI 0.69-0.79]; p < 0.001). When patients were treated in a non-trauma system compared to a trauma system the odds of mortality rates increased (OR 1.17 [95% CI 1.10-1.24]; p < 0.001). When patients were treated in a post-implementation/initial system compared to a mature system, odds of mortality were significantly higher (OR 1.46 [95% CI 1.37-1.55]; p < 0.001). CONCLUSION: The present study highlights that the survival of traumatic injured patients varies according to the stage of trauma system development in which the patient was treated. The analysis indicates a significant reduction in mortality following the introduction of the trauma system which is further enhanced as the system matures. These results provide evidence to support efforts to, firstly, implement trauma systems in countries currently without and, secondly, to enhance existing systems by investing in system development. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42019142842 .
Authors: K John McConnell; Craig D Newgard; Richard J Mullins; Melanie Arthur; Jerris R Hedges Journal: Health Serv Res Date: 2005-04 Impact factor: 3.402
Authors: Jeffrey A Claridge; William H Leukhardt; Joseph F Golob; Andrew M McCoy; Mark A Malangoni Journal: J Am Coll Surg Date: 2010-05 Impact factor: 6.113
Authors: Lynne Moore; Howard Champion; Pier-Alexandre Tardif; Brice-Lionel Kuimi; Gerard O'Reilly; Ari Leppaniemi; Peter Cameron; Cameron S Palmer; Fikri M Abu-Zidan; Belinda Gabbe; Christine Gaarder; Natalie Yanchar; Henry Thomas Stelfox; Raul Coimbra; John Kortbeek; Vanessa K Noonan; Amy Gunning; Malcolm Gordon; Monty Khajanchi; Teegwendé V Porgo; Alexis F Turgeon; Luke Leenen Journal: World J Surg Date: 2018-05 Impact factor: 3.352
Authors: Periklis Charalampous; Elena Pallari; Vanessa Gorasso; Elena von der Lippe; Brecht Devleesschauwer; Sara M Pires; Dietrich Plass; Jane Idavain; Che Henry Ngwa; Isabel Noguer; Alicia Padron-Monedero; Rodrigo Sarmiento; Marek Majdan; Balázs Ádám; Ala'a AlKerwi; Seila Cilovic-Lagarija; Benjamin Clarsen; Barbara Corso; Sarah Cuschieri; Keren Dopelt; Mary Economou; Florian Fischer; Alberto Freitas; Juan Manuel García-González; Federica Gazzelloni; Artemis Gkitakou; Hakan Gulmez; Paul Hynds; Gaetano Isola; Lea S Jakobsen; Zubair Kabir; Katarzyna Kissimova-Skarbek; Ann Kristin Knudsen; Naime Meriç Konar; Carina Ladeira; Brian Lassen; Aaron Liew; Marjeta Majer; Enkeleint A Mechili; Alibek Mereke; Lorenzo Monasta; Stefania Mondello; Joana Nazaré Morgado; Evangelia Nena; Edmond S W Ng; Vikram Niranjan; Iskra Alexandra Nola; Rónán O'Caoimh; Panagiotis Petrou; Vera Pinheiro; Miguel Reina Ortiz; Silvia Riva; Hanen Samouda; João Vasco Santos; Cornelia Melinda Adi Santoso; Milena Santric Milicevic; Dimitrios Skempes; Ana Catarina Sousa; Niko Speybroeck; Fimka Tozija; Brigid Unim; Hilal Bektaş Uysal; Fabrizio Giovanni Vaccaro; Orsolya Varga; Milena Vasic; Francesco Saverio Violante; Grant M A Wyper; Suzanne Polinder; Juanita A Haagsma Journal: BMC Public Health Date: 2022-08-17 Impact factor: 4.135