Table 1.
Characteristics of the two trauma patient cohorts, stratified by total out-of-hospital time.
| Shock cohort, n = 778 | TBI cohort, n = 1,239 | |||
|---|---|---|---|---|
| Out-of-hospital time ≤ 60 minutes | Out-of-hospital time > 60 minutes | Out-of-hospital time ≤ 60 minutes | Out-of-hospital time > 60 minutes | |
| n = 604 | n = 174 | n = 914 | n = 325 | |
| Demographics: | ||||
| Age in years – median (IQR) | 31 (23-45) | 38 (26-54) | 35 (24-52) | 33 (22-47) |
| Women (%) | 121 (20) | 52 (30) | 211 (23) | 84 (26) |
| Out-of-hospital physiology and procedures: | ||||
| SBP in mmHg – median (IQR) | 68 (ND**-80) | 70 (60-85) | 130 (111-150) | 130 (110-147) |
| GCS – median (IQR) | 12 (4-15) | 11 (3-15) | 4 (3-7) | 5 (3-7) |
| Heart rate in beats/minute – median (IQR) | 120 (108-132) | 120 (110-135) | 101 (86-120) | 110 (93-125) |
| Advanced airway attempt (%) | 223 (37) | 94 (54) | 521 (57) | 282 (87) |
| Air medical transport (%) | 92 (15) | 119 (68) | 242 (26) | 255 (78) |
| Mechanism of Injury: | ||||
| Gunshot wound (%) | 154 (25) | 9 (5) | 16 (2) | 2 (1) |
| Stabbing/impalement (%) | 99 (16) | 9 (5) | 2 (0) | 0 (0) |
| Other penetrating (%) | 16 (3) | 1 (1) | 0 (0) | 0 (0) |
| Motor vehicle crash (MVC) - occupant (%) | 127 (21) | 93 (53) | 300 (33) | 181 (56) |
| Motorcyclist (%) | 49 (8) | 23 (13) | 87 (10) | 38 (12) |
| MVC – Bicyclist/Pedestrian (%) | 65 (11) | 10 (6) | 161 (18) | 22 (7) |
| Fall (%) | 55 (9) | 13 (7) | 207 (23) | 39 (12) |
| Assault (%) | 21 (3) | 2 (1) | 86 (9) | 13 (4) |
| Other blunt (%) | 18 (3) | 14 (8) | 54 (6) | 30 (9) |
| Hospital measures: | ||||
| Transport to Level I (%) | 527 (87) | 160 (92) | 762 (83) | 307 (94) |
| Transport to Level II (%) | 72 (12) | 12 (7) | 140 (15) | 18 (6) |
| Injury severity: | ||||
| Median ISS (IQR) | 22 (10-34) | 25 (17-34) | 25 (14-34) | 29 (21-41) |
| ISS >= 16 (%) | 407 (67) | 137 (79) | 673 (74) | 278 (86) |
| Hospital resources within the 1st 24 hours: | ||||
| Median PRBC transfusion (IQR) | 2 (0-7) | 2 (0-6) | 0 (0-0) | 0 (0-2) |
| PRBC transfusion ≤ 1 unit (%) | 370 (61) | 101 (58) | 218 (24) | 98 (30) |
| PRBC transfusion ≤ 6 units (%) | 173 (29) | 45 (26) | 62 (7) | 31 (10) |
| Craniotomy (%) | 16 (3) | 6 (3) | 129 (14) | 41 (13) |
| Thoracic surgery (%) | 84 (14) | 17 (10) | 14 (2) | 5 (2) |
| Abdominal or pelvic surgery (%) | 179 (30) | 36 (21) | 51 (6) | 24 (7) |
| Peripheral vascular surgery (%) | 55 (9) | 7 (4) | 2 (0) | 3 (1) |
| Neck surgery (%) | 9 (1) | 1 (1) | 0 (0) | 1 (0) |
| Interventional radiology procedures (%) | 45 (7) | 11 (6) | 16 (2) | 5 (2) |
| Open fixation of fracture (%) | 69 (11) | 29 (17) | 59 (6) | 21 (6) |
| Critical resource use within 24 hours* (%) | 391 (65) | 93 (53) | 293 (32) | 109 (34) |
| Outcomes: | ||||
| Death within 1st 24 hours (%) | 127 (21) | 37 (21) | 114 (13) | 41 (13) |
| In-hospital mortality (%) | 159 (26) | 48 (28) | 226 (25) | 83 (26) |
| 28-day mortality (%) | 157 (26) | 46 (26) | 225 (25) | 78 (24) |
| 6-month GOSE ≤ 4 (%) | - - | - - | 473 (52) | 179 (55) |
Abbreviations: GCS, Glasgow Coma Scale; GOSE, Glasgow Outcome Scale-Extended; IQR, interquartile range; ISS, Injury Severity Score; PRBC, packed red blood cells; SBP, systolic blood pressure; TBI, traumatic brain injury.
*
Critical resource use was defined as any of the following within 24 hours of emergency department arrival: packed red blood cell transfusion ≥ 6 units, major non-orthopedic surgical procedures (brain, spine, neck, thoracic, abdominal, pelvic and vascular), interventional radiology procedures or death
**
ND, not detectable