Dataset Information

Association of Police Transport With Survival Among Patients With Penetrating Trauma in Philadelphia, Pennsylvania.

ABSTRACT:

Importance

Police in Philadelphia, Pennsylvania, routinely transport patients with penetrating trauma to nearby trauma centers. During the past decade, this practice has gained increased acceptance, but outcomes resulting from police transport of these patients have not been recently evaluated.

Objective

To assess mortality among patients with penetrating trauma who are transported to trauma centers by police vs by emergency medical services (EMS).

Design, setting, and participants

This cohort study used the Pennsylvania Trauma Outcomes Study registry and included 3313 adult patients with penetrating trauma from January 1, 2014, to December 31, 2018. Outcomes were compared between patients transported by police (n?=?1970) and patients transported by EMS (n?=?1343) to adult level I and II trauma centers in Philadelphia.

Exposures

Police vs EMS transport.

Main outcomes and measures

The primary end point was 24-hour mortality. Secondary end points included death at multiple other time points. After whole-cohort regression analysis, coarsened exact matching was used to control for confounding differences between groups. Matching criteria included patient age, injury mechanism and location, Injury Severity Score (ISS), presenting systolic blood pressure, and Glasgow Coma Scale score. Subgroup analysis was performed among patients with low, moderate, or high ISS.

Results

Of the 3313 patients (median age, 29 years [interquartile range, 23-40 years]) in the study, 3013 (90.9%) were men. During the course of the study, the number of police transports increased significantly (from 328 patients in 2014 to 489 patients in 2018; P?=?.04), while EMS transport remained unchanged (from 246 patients in 2014 to 281 patients in 2018; P?=?.44). On unadjusted analysis, compared with patients transported by EMS, patients transported by police were younger (median age, 27 years [interquartile range, 22-36 years] vs 32 years [interquartile range, 24-46 years]), more often injured by a firearm (1741 of 1970 [88.4%] vs 681 of 1343 [50.7%]), and had a higher median ISS (14 [interquartile range, 9-26] vs 10 [interquartile range, 5-17]). Patients transported by police had higher mortality at 24 hours than those transported by EMS (560 of 1970 [28.4%] vs 246 of 1343 [18.3%]; odds ratio, 1.86; 95% CI, 1.57-2.21; P?Conclusions and relevanceFor patients with penetrating trauma in an urban setting, 24-hour mortality was not different for those transported by police vs EMS to a trauma center. Timely transport to definitive trauma care should be emphasized over medical capability in the prehospital management of patients with penetrating trauma.

SUBMITTER: Winter E

PROVIDER: S-EPMC7835719 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Association of Police Transport With Survival Among Patients With Penetrating Trauma in Philadelphia, Pennsylvania.

Winter Eric E Hynes Allyson M AM Shultz Kaitlyn K Holena Daniel N DN Malhotra Neil R NR Cannon Jeremy W JW

JAMA network open 20210104 1

<h4>Importance</h4>Police in Philadelphia, Pennsylvania, routinely transport patients with penetrating trauma to nearby trauma centers. During the past decade, this practice has gained increased acceptance, but outcomes resulting from police transport of these patients have not been recently evaluated.<h4>Objective</h4>To assess mortality among patients with penetrating trauma who are transported to trauma centers by police vs by emergency medical services (EMS).<h4>Design, setting, and particip ...[more]

PMID: 33492375

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Dataset Information

Association of Police Transport With Survival Among Patients With Penetrating Trauma in Philadelphia, Pennsylvania.

Importance

Objective

Design, setting, and participants

Exposures

Main outcomes and measures

Results

Publications

Association of Police Transport With Survival Among Patients With Penetrating Trauma in Philadelphia, Pennsylvania.

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