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J Korean Soc Emerg Med > Volume 29(5); 2018 > Article
Journal of The Korean Society of Emergency Medicine 2018;29(5): 415-422.
비외상센터에서 외상센터로의 전원이 예후에 미치는 영향
양욱태, 민문기, 류지호, 이대섭, 이강호, 신진욱, 염석란, 한상균
부산대학교 의학전문대학원 응급의학교실
Impact of interhospital transfer on outcomes for trauma patients: impact of direct versus non-direct transfer
Wook Tae Yang, Mun Ki Min, Ji Ho Ryu, Daesup Lee, Kang Ho Lee, Jin Wook Shin, Seok Ran Yeom, Sang Kyun Han
Department of Emergency Medicine, Pusan National University School of Medicine, Busan, Korea
Correspondence  Mun Ki Min ,Tel: 055-360-2143, Fax: 055-360-2173, Email: minmk99@pusan.ac.kr,
Received: March 15, 2018; Revised: May 5, 2018   Accepted: June 11, 2018.  Published online: October 31, 2018.
ABSTRACT
Objective:
This study compared the prognosis of patients who visited the trauma center directly (direct visit group) with those transferred from the non-trauma center (transferred group).
Method:
The patients, who were 18 or older with Injury Severity Score of 15 or more in the trauma center at Busan, were studied from October 2015 to October 2016. To compare the treatment time between the direct visit and transferred group, first treatment time, final treatment time, and time to visit the trauma center were examined. To compare the prognosis, this study compared the 48-hour, 7-day, and in-hospital mortality rate as well as the duration of intensive care unit (ICU) and total hospital stay. To analyze the factors affecting the outcome of transferred group, the physician’s level and procedures that had been performed at the non-trauma center were examined.
Results:
The mortality was similar in the direct visit and transferred group (48-hour 7.6% vs. 4.6%, P=0.111; 7-day 11.1% vs. 7.2%, P=0.89; and in-hospital 14.6% vs. 11.3%, P=0.214). The length of ICU and total hospital stay were similar in the two groups. The mortality was higher in the patients in the transferred group when using intubation, transfusion, and pressure intensifier. The intubated patients showed higher mortality according to logistic regression.
Conclusion:
The mortality, length of ICU, and hospital stay were similar but the time to visit the trauma center and the final treatment time were longer in transferred group. Stabilizing the patient at the near non-trauma center may be more helpful for some patients.
Key words: Injuries; Patient transfer; Mortality
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