The Effect of Interhospital Transfers on the Outcome of Rural Trauma

Abstract

Urban areas house the majority of the population in the United States but trauma deaths occur more commonly in rural areas. In this study, we aimed to investigate if direct patient admission to a Level I trauma center improves outcomes in rural trauma. We retrospectively reviewed data in our trauma database from January 2008 to the end of December 2012 to compare the overall outcomes between direct admissions (DAs) and interhospital transfers (IHTs). Of the 6118 patients who met the inclusion criteria, 59.5 per cent were in the DA group and 40.5 per cent in the IHT group. Injury severity score was similar between the two groups but severe traumatic brain injury was more common (P = 0.001) in the DA group. Hospital length of stay, complication rate, and in-hospital mortality were not different between the two groups (all P > 0.2). In multivariate analysis, there was no difference in survival between the two modes of admission (odds ratio, 95% confidence interval: 0.91, 0.69–1.20, P = 0.51). We concluded that rural trauma IHTs had no detrimental impact on the outcome. Prospective studies would better elucidate factors associated with patient outcomes in rural trauma.

Impact of Inter‐Hospital Transfer on Outcomes in Patients Undergoing Emergency Abdominal Surgery: A Tertiary Referral Center's Perspective

“…The effect of inter-hospital transfer to tertiary referral centers on patient outcomes has been studied extensively in trauma patients [1][2][3][4] or patients suffering from ruptured aortic aneurysms [5,6]. In non-trauma patients undergoing emergency abdominal surgery (EAS) for septic conditions, however, the literature on the effect of inter-hospital transfer is limited [7][8][9][10].…”

Comparison between urban and rural mortality in patients with acute myocardial infarction: a nationwide longitudinal cohort study in South Korea

“…6 7 Most medical centres that can offer specialised care are concentrated in urban areas with higher population densities and higher incomes, and correspondingly, rural areas experience shortages of specialised care facilities and personnel, which hinders the provision of appropriate and timely emergency medical care. [8][9][10] The Emergency Medical Service Act in Korea divides emergency medical institutions into regional emergency medical centre, local emergency medical centre and local emergency medical facilities. In terms of medical resources, the emergency medical centre is a hospital equipped with more specialised facilities and human Open access resources than is an emergency medical facility.…”

Is it a matter of time? The effect of transfer time on femur fracture outcomes

“…When appropriately and expediently transferred, transfer patients seem to do as well as patients admitted directly to the trauma center 6 ; however, delayed transfers or failure to transfer is associated with decreased survival. 7 Recently, improved patient outcomes and decreased length of stay have been associated with femur fracture repair within 24 hours of admission.…”