An analysis of police transport in an Eastern Association for the Surgery of Trauma multicenter trial examining prehospital procedures in penetrating trauma patients

Sharven Taghavi; Zoe Maher; Amy J. Goldberg; Elliott R. Haut; Shariq Raza; Grace Chang; Leah C. Tatebe; Eman Toraih; Michelle Mendiola; Christofer Anderson; Scott Ninokawa; Patrick Maluso; Jane Keating; Sigrid Burruss; Matthew Reeves; Lauren E. Coleman; David V. Shatz; Anna Goldenberg-Sandau; Apoorva Bhupathi; M. Chance Spalding; Aimee Lariccia; Emily Bird; Matthew R. Noorbakhsh; James Babowice; Marsha C. Nelson; Lewis E. Jacobson; Jamie Williams; Michael Vella; Kate Dellonte; Thomas Z. Hayward; Emma Holler; Mark J. Lieser; John D. Berne; Dalier R. Mederos; Reza Askari; Barbara Okafor; Eric Etchill; Raymond Fang; Samantha L. Roche; Laura Whittenburg; Andrew C. Bernard; James M. Haan; Kelly L. Lightwine; Scott H. Norwood; Jason Murry; Mark A. Gamber; Matthew M. Carrick; Nikolay Bugaev; Antony Tatar; Danielle Tatum

doi:10.1097/TA.0000000000003563

An analysis of police transport in an Eastern Association for the Surgery of Trauma multicenter trial examining prehospital procedures in penetrating trauma patients

Sharven Taghavi, Zoe Maher, Amy J. Goldberg, Elliott R. Haut, Shariq Raza, Grace Chang, Leah C. Tatebe, Eman Toraih, Michelle Mendiola, Christofer Anderson, Scott Ninokawa, Patrick Maluso, Jane Keating, Sigrid Burruss, Matthew Reeves, Lauren E. Coleman, David V. Shatz, Anna Goldenberg-Sandau, Apoorva Bhupathi, M. Chance SpaldingAimee Lariccia, Emily Bird, Matthew R. Noorbakhsh, James Babowice, Marsha C. Nelson, Lewis E. Jacobson, Jamie Williams, Michael Vella, Kate Dellonte, Thomas Z. Hayward, Emma Holler, Mark J. Lieser, John D. Berne, Dalier R. Mederos, Reza Askari, Barbara Okafor, Eric Etchill, Raymond Fang, Samantha L. Roche, Laura Whittenburg, Andrew C. Bernard, James M. Haan, Kelly L. Lightwine, Scott H. Norwood, Jason Murry, Mark A. Gamber, Matthew M. Carrick, Nikolay Bugaev, Antony Tatar, Danielle Tatum

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND Police transport (PT) of penetrating trauma patients in urban locations has become routine in certain metropolitan areas; however, whether it results in improved outcomes over prehospital Advanced life support (ALS) transport has not been determined in a multicenter study. We hypothesized that PT would not result in improved outcomes. METHODS This was a multicenter, prospective, observational study of adults (18+ years) with penetrating trauma to the torso and/or proximal extremity presenting at 25 urban trauma centers. Police transport and ALS patients were allocated via nearest neighbor, propensity matching. Transport mode also examined by Cox regression. RESULTS Of 1,618 total patients, 294 (18.2%) had PT and 1,324 (81.8%) were by ALS. After matching, 588 (294/cohort) remained. The patients were primarily Black (n = 497, 84.5%), males (n = 525, 89.3%, injured by gunshot wound (n = 494, 84.0%) with 34.5% (n = 203) having Injury Severity Score of 16 or higher. Overall mortality by propensity matching was not different between cohorts (15.6% ALS vs. 15.0% PT, p = 0.82). In severely injured patients (Injury Severity Score ≥16), mortality did not differ between PT and ALS transport (38.8% vs. 36.0%, respectively; p = 0.68). Cox regression analysis controlled for relevant factors revealed no association with a mortality benefit in patients transported by ALS. CONCLUSION Police transport of penetrating trauma patients in urban locations results in similar outcomes compared with ALS. Immediate transport to definitive trauma care should be emphasized in this patient population. LEVEL OF EVIDENCE Prognostic and Epidemiologic; Level III.

Original language	English (US)
Pages (from-to)	265-272
Number of pages	8
Journal	Journal of Trauma and Acute Care Surgery
Volume	93
Issue number	2
DOIs	https://doi.org/10.1097/TA.0000000000003563
State	Published - Aug 1 2022
Externally published	Yes

Keywords

Penetrating trauma
emergency medical services
mortality
outcomes
police transport

ASJC Scopus subject areas

Critical Care and Intensive Care Medicine
Surgery

Access to Document

10.1097/TA.0000000000003563

Cite this

Taghavi, S., Maher, Z., Goldberg, A. J., Haut, E. R., Raza, S., Chang, G., Tatebe, L. C., Toraih, E., Mendiola, M., Anderson, C., Ninokawa, S., Maluso, P., Keating, J., Burruss, S., Reeves, M., Coleman, L. E., Shatz, D. V., Goldenberg-Sandau, A., Bhupathi, A., ... Tatum, D. (2022). An analysis of police transport in an Eastern Association for the Surgery of Trauma multicenter trial examining prehospital procedures in penetrating trauma patients. Journal of Trauma and Acute Care Surgery, 93(2), 265-272. https://doi.org/10.1097/TA.0000000000003563

An analysis of police transport in an Eastern Association for the Surgery of Trauma multicenter trial examining prehospital procedures in penetrating trauma patients. / Taghavi, Sharven; Maher, Zoe; Goldberg, Amy J. et al.
In: Journal of Trauma and Acute Care Surgery, Vol. 93, No. 2, 01.08.2022, p. 265-272.

Research output: Contribution to journal › Article › peer-review

Taghavi, S, Maher, Z, Goldberg, AJ, Haut, ER, Raza, S, Chang, G, Tatebe, LC, Toraih, E, Mendiola, M, Anderson, C, Ninokawa, S, Maluso, P, Keating, J, Burruss, S, Reeves, M, Coleman, LE, Shatz, DV, Goldenberg-Sandau, A, Bhupathi, A, Spalding, MC, Lariccia, A, Bird, E, Noorbakhsh, MR, Babowice, J, Nelson, MC, Jacobson, LE, Williams, J, Vella, M, Dellonte, K, Hayward, TZ, Holler, E, Lieser, MJ, Berne, JD, Mederos, DR, Askari, R, Okafor, B, Etchill, E, Fang, R, Roche, SL, Whittenburg, L, Bernard, AC, Haan, JM, Lightwine, KL, Norwood, SH, Murry, J, Gamber, MA, Carrick, MM, Bugaev, N, Tatar, A & Tatum, D 2022, 'An analysis of police transport in an Eastern Association for the Surgery of Trauma multicenter trial examining prehospital procedures in penetrating trauma patients', Journal of Trauma and Acute Care Surgery, vol. 93, no. 2, pp. 265-272. https://doi.org/10.1097/TA.0000000000003563

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title = "An analysis of police transport in an Eastern Association for the Surgery of Trauma multicenter trial examining prehospital procedures in penetrating trauma patients",

abstract = "BACKGROUND Police transport (PT) of penetrating trauma patients in urban locations has become routine in certain metropolitan areas; however, whether it results in improved outcomes over prehospital Advanced life support (ALS) transport has not been determined in a multicenter study. We hypothesized that PT would not result in improved outcomes. METHODS This was a multicenter, prospective, observational study of adults (18+ years) with penetrating trauma to the torso and/or proximal extremity presenting at 25 urban trauma centers. Police transport and ALS patients were allocated via nearest neighbor, propensity matching. Transport mode also examined by Cox regression. RESULTS Of 1,618 total patients, 294 (18.2%) had PT and 1,324 (81.8%) were by ALS. After matching, 588 (294/cohort) remained. The patients were primarily Black (n = 497, 84.5%), males (n = 525, 89.3%, injured by gunshot wound (n = 494, 84.0%) with 34.5% (n = 203) having Injury Severity Score of 16 or higher. Overall mortality by propensity matching was not different between cohorts (15.6% ALS vs. 15.0% PT, p = 0.82). In severely injured patients (Injury Severity Score ≥16), mortality did not differ between PT and ALS transport (38.8% vs. 36.0%, respectively; p = 0.68). Cox regression analysis controlled for relevant factors revealed no association with a mortality benefit in patients transported by ALS. CONCLUSION Police transport of penetrating trauma patients in urban locations results in similar outcomes compared with ALS. Immediate transport to definitive trauma care should be emphasized in this patient population. LEVEL OF EVIDENCE Prognostic and Epidemiologic; Level III.",

keywords = "Penetrating trauma, emergency medical services, mortality, outcomes, police transport",

author = "Sharven Taghavi and Zoe Maher and Goldberg, {Amy J.} and Haut, {Elliott R.} and Shariq Raza and Grace Chang and Tatebe, {Leah C.} and Eman Toraih and Michelle Mendiola and Christofer Anderson and Scott Ninokawa and Patrick Maluso and Jane Keating and Sigrid Burruss and Matthew Reeves and Coleman, {Lauren E.} and Shatz, {David V.} and Anna Goldenberg-Sandau and Apoorva Bhupathi and Spalding, {M. Chance} and Aimee Lariccia and Emily Bird and Noorbakhsh, {Matthew R.} and James Babowice and Nelson, {Marsha C.} and Jacobson, {Lewis E.} and Jamie Williams and Michael Vella and Kate Dellonte and Hayward, {Thomas Z.} and Emma Holler and Lieser, {Mark J.} and Berne, {John D.} and Mederos, {Dalier R.} and Reza Askari and Barbara Okafor and Eric Etchill and Raymond Fang and Roche, {Samantha L.} and Laura Whittenburg and Bernard, {Andrew C.} and Haan, {James M.} and Lightwine, {Kelly L.} and Norwood, {Scott H.} and Jason Murry and Gamber, {Mark A.} and Carrick, {Matthew M.} and Nikolay Bugaev and Antony Tatar and Danielle Tatum",

note = "Funding Information: E.R.H. reports research funding from The Patient-Centered Outcomes Research Institute (PCORI), the Agency for Healthcare Research and Quality (AHRQ), the NIH/NHLBI, the DOD/Army Medical Research Acquisition Activity, and the Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF). E.R.H. receives royalties from Lippincott, Williams, Wilkins for a book—“Avoiding Common ICU Errors.” E.R.H. was a paid speaker for the Vizient Hospital Improvement Innovation Network (HIIN) VTE Prevention Acceleration Network. Publisher Copyright: {\textcopyright} Wolters Kluwer Health, Inc. All rights reserved.",

year = "2022",

month = aug,

day = "1",

doi = "10.1097/TA.0000000000003563",

language = "English (US)",

volume = "93",

pages = "265--272",

journal = "Journal of Trauma and Acute Care Surgery",

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publisher = "Lippincott Williams and Wilkins",

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TY - JOUR

T1 - An analysis of police transport in an Eastern Association for the Surgery of Trauma multicenter trial examining prehospital procedures in penetrating trauma patients

AU - Taghavi, Sharven

AU - Maher, Zoe

AU - Goldberg, Amy J.

AU - Haut, Elliott R.

AU - Raza, Shariq

AU - Chang, Grace

AU - Tatebe, Leah C.

AU - Toraih, Eman

AU - Mendiola, Michelle

AU - Anderson, Christofer

AU - Ninokawa, Scott

AU - Maluso, Patrick

AU - Keating, Jane

AU - Burruss, Sigrid

AU - Reeves, Matthew

AU - Coleman, Lauren E.

AU - Shatz, David V.

AU - Goldenberg-Sandau, Anna

AU - Bhupathi, Apoorva

AU - Spalding, M. Chance

AU - Lariccia, Aimee

AU - Bird, Emily

AU - Noorbakhsh, Matthew R.

AU - Babowice, James

AU - Nelson, Marsha C.

AU - Jacobson, Lewis E.

AU - Williams, Jamie

AU - Vella, Michael

AU - Dellonte, Kate

AU - Hayward, Thomas Z.

AU - Holler, Emma

AU - Lieser, Mark J.

AU - Berne, John D.

AU - Mederos, Dalier R.

AU - Askari, Reza

AU - Okafor, Barbara

AU - Etchill, Eric

AU - Fang, Raymond

AU - Roche, Samantha L.

AU - Whittenburg, Laura

AU - Bernard, Andrew C.

AU - Haan, James M.

AU - Lightwine, Kelly L.

AU - Norwood, Scott H.

AU - Murry, Jason

AU - Gamber, Mark A.

AU - Carrick, Matthew M.

AU - Bugaev, Nikolay

AU - Tatar, Antony

AU - Tatum, Danielle

N1 - Funding Information: E.R.H. reports research funding from The Patient-Centered Outcomes Research Institute (PCORI), the Agency for Healthcare Research and Quality (AHRQ), the NIH/NHLBI, the DOD/Army Medical Research Acquisition Activity, and the Henry M. Jackson Foundation for the Advancement of Military Medicine (HJF). E.R.H. receives royalties from Lippincott, Williams, Wilkins for a book—“Avoiding Common ICU Errors.” E.R.H. was a paid speaker for the Vizient Hospital Improvement Innovation Network (HIIN) VTE Prevention Acceleration Network. Publisher Copyright: © Wolters Kluwer Health, Inc. All rights reserved.

PY - 2022/8/1

Y1 - 2022/8/1

N2 - BACKGROUND Police transport (PT) of penetrating trauma patients in urban locations has become routine in certain metropolitan areas; however, whether it results in improved outcomes over prehospital Advanced life support (ALS) transport has not been determined in a multicenter study. We hypothesized that PT would not result in improved outcomes. METHODS This was a multicenter, prospective, observational study of adults (18+ years) with penetrating trauma to the torso and/or proximal extremity presenting at 25 urban trauma centers. Police transport and ALS patients were allocated via nearest neighbor, propensity matching. Transport mode also examined by Cox regression. RESULTS Of 1,618 total patients, 294 (18.2%) had PT and 1,324 (81.8%) were by ALS. After matching, 588 (294/cohort) remained. The patients were primarily Black (n = 497, 84.5%), males (n = 525, 89.3%, injured by gunshot wound (n = 494, 84.0%) with 34.5% (n = 203) having Injury Severity Score of 16 or higher. Overall mortality by propensity matching was not different between cohorts (15.6% ALS vs. 15.0% PT, p = 0.82). In severely injured patients (Injury Severity Score ≥16), mortality did not differ between PT and ALS transport (38.8% vs. 36.0%, respectively; p = 0.68). Cox regression analysis controlled for relevant factors revealed no association with a mortality benefit in patients transported by ALS. CONCLUSION Police transport of penetrating trauma patients in urban locations results in similar outcomes compared with ALS. Immediate transport to definitive trauma care should be emphasized in this patient population. LEVEL OF EVIDENCE Prognostic and Epidemiologic; Level III.

AB - BACKGROUND Police transport (PT) of penetrating trauma patients in urban locations has become routine in certain metropolitan areas; however, whether it results in improved outcomes over prehospital Advanced life support (ALS) transport has not been determined in a multicenter study. We hypothesized that PT would not result in improved outcomes. METHODS This was a multicenter, prospective, observational study of adults (18+ years) with penetrating trauma to the torso and/or proximal extremity presenting at 25 urban trauma centers. Police transport and ALS patients were allocated via nearest neighbor, propensity matching. Transport mode also examined by Cox regression. RESULTS Of 1,618 total patients, 294 (18.2%) had PT and 1,324 (81.8%) were by ALS. After matching, 588 (294/cohort) remained. The patients were primarily Black (n = 497, 84.5%), males (n = 525, 89.3%, injured by gunshot wound (n = 494, 84.0%) with 34.5% (n = 203) having Injury Severity Score of 16 or higher. Overall mortality by propensity matching was not different between cohorts (15.6% ALS vs. 15.0% PT, p = 0.82). In severely injured patients (Injury Severity Score ≥16), mortality did not differ between PT and ALS transport (38.8% vs. 36.0%, respectively; p = 0.68). Cox regression analysis controlled for relevant factors revealed no association with a mortality benefit in patients transported by ALS. CONCLUSION Police transport of penetrating trauma patients in urban locations results in similar outcomes compared with ALS. Immediate transport to definitive trauma care should be emphasized in this patient population. LEVEL OF EVIDENCE Prognostic and Epidemiologic; Level III.

KW - Penetrating trauma

KW - emergency medical services

KW - mortality

KW - outcomes

KW - police transport

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An analysis of police transport in an Eastern Association for the Surgery of Trauma multicenter trial examining prehospital procedures in penetrating trauma patients

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