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Epidemiology of patients assessed for trauma by Swedish ambulance services: a retrospective registry study
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. Department of Prehospital Emergency Care, Sahlgrenska University Hospital, Gothenburg, Sweden; PICTA, Prehospital Innovation Arena, Lindholmen Science Park, Gothenburg, Sweden. (PreHospen)
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. PreHospen. (PreHospen)ORCID iD: 0000-0001-6505-9132
University of Borås, Faculty of Caring Science, Work Life and Social Welfare.
University of Borås, Faculty of Caring Science, Work Life and Social Welfare. (PreHospen)ORCID iD: 0000-0003-4139-6235
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2024 (English)In: BMC Emergency Medicine, E-ISSN 1471-227X, Vol. 24, no 1, article id 11Article in journal (Refereed) Published
Abstract [en]

Background

There is a lack of knowledge regarding the epidemiology of severe trauma assessed by Swedish emergency medical services (EMS).

Aim

To investigate the prevalence of trauma in Sweden assessed by EMS from a national perspective and describe patient demography, aetiology, trauma type, prehospital triage and clinical outcomes.

Methods

Data from two national quality registries, the Swedish Ambulance Registry and the Swedish Trauma Registry (SweTrau) were collected from January 1 to December 31, 2019. Inclusion criteria were an Emergency Symptoms and Signs code equivalent to trauma in the Swedish Ambulance Registry and criteria fulfilled for SweTrau inclusion. Exclusion criteria were patients < 18 years old, those not transported to a hospital and those without a personal identification number.

Results

In total, 53,120 patients with trauma were included (14% of primary EMS missions involving a personal identification number). Of those, 2,278 (4.3%) patients (median age: 45 years; 32% women) were reported in SweTrau to have severe or potentially severe trauma (penetrating: 7%, blunt: 93%). In terms of including all causes of trauma, the code for ‘trauma alert activation’ was most frequent (55%). The most frequent injury mechanism was an injury caused by a car (34%). Most (89%) cases were assigned Priority 1 (life-threatening condition) at the dispatch centre. 62% were regarded as potentially life threatening upon EMS arrival, whereas 29% were assessed as non-life-threatening. Overall, 25% of the patients had new injury severity scores > 15. 12% required invasive treatment, 11% were discharged with severe disability and the 30-day mortality rate was 3.6%.

Conclusion

In this cross-sectional study, 14% of the primary EMS missions for one year were caused by trauma. However, only a small proportion of these cases are severe injuries, and the risk of severe disabilities and death appears to be limited. The most frequent aetiology of a severe trauma is injury caused by a car, and most severe traumas are blunt. Severe traumas are given the highest priority at the dispatch centre in the vast majority of cases, but nearly one-third of these cases are considered a low priority by the EMS nurse. The latter leaves room for improvement.

Place, publisher, year, edition, pages
2024. Vol. 24, no 1, article id 11
Keywords [en]
Trauma, Injury, Emergency medical services, Ambulance services, Patient, Severity, Mortality
National Category
Nursing
Research subject
The Human Perspective in Care; The Human Perspective in Care
Identifiers
URN: urn:nbn:se:hb:diva-31161DOI: 10.1186/s12873-023-00924-5ISI: 001138257800002Scopus ID: 2-s2.0-85181723478OAI: oai:DiVA.org:hb-31161DiVA, id: diva2:1825730
Available from: 2024-01-10 Created: 2024-01-10 Last updated: 2024-02-01Bibliographically approved

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Larsson, GlennAxelsson, ChristerAndersson Hagiwara, MagnusHerlitz, Johan

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