Table 2 Coded summaries of included full text articles
From: A scoping review of worldwide studies evaluating the effects of prehospital time on trauma outcomes
Article reference | Category | EMS System | Setting | Country | Design | Time | Primary Outcome | Secondary Outcome | Primary Exposure(s) | Grade |
|---|---|---|---|---|---|---|---|---|---|---|
Aiolfi (2018) [23] | Outcomes due to H-EMS vs G-EMS | Both | B | USA | O | Key exposure | In-hospital mortality | ICU LOS; hospital LOS | TBI; transport modality | Low |
Al Thani (2014) [24] | Effect of PH intervention on outcomes | Both | B | Qatar | O | Covariate | PH and in-hospital mortality | - | Trauma; intubation | Low |
Alarhayem et al. [25] | Miscellaneous | Both | B | USA | O | Key exposure | In-hospital mortality | - | Non-compressible torso trauma; PHT | Low |
Anderson (2019) [26] | Miscellaneous | Both | C | Multiple | O | Key exposure | 30-day survival | Predictors of survival | Traumatic cardiac arrest | Low |
Andruszkow et al. [27] | Outcomes due to H-EMS vs G-EMS | Both | B | Germany | O | Covariate | In-hospital mortality | Multiple organ dysfunction syndrome and/or sepsis | Transport modality | Low |
Bagher et al. [28] | G-EMS: time/distance vs mortality | G-EMS | CU | Sweden | O | Key exposure | Mortality | - | Total PH time, on scene time, PH rescue times | Low |
Berlot et al. [29] | Outcomes due to H-EMS vs G-EMS | Both | B | Italy | O | Key exposure | Survival to discharge neurologic disability | - | TBI; transport modality | Low |
Borst et al. [30] | Outcomes due to H-EMS vs G-EMS | Both | B | USA | O | Key exposure | In-hospital mortality | - | Trauma center transfer; transport modality | Low |
Boschini (2016) [31] | Mortality due to primary vs secondary transfer | Both | B | Malawi | O | Covariate | In-hospital mortality | - | Primary versus secondary transfer to tertiary trauma center | Low |
Botchey et al. [32] | Miscellaneous | Both | B | Kenya | O | Covariate | In-hospital mortality | - | Trauma | Low |
Boudreau (2019) [33] | Effect of PH intervention on outcomes | Air | CU | USA | O | Covariate | In-hospital mortality | VTE development | Trauma; PH TXA administration in H-EMS | Low |
Brazinova et al. [34] | Physiologic variables predicting outcomes in TBI | Both | B | Austria | O | Covariate | In-hospital mortality | Favorable neurologic outcomes | TBI; recommended early interventions | Low |
Brorsson et al. [35] | Physiologic variables predicting outcomes in TBI | Both | B | Sweden | O | Key exposure | Mortality at 3 months post injury | Neurologic outcomes based on Glasgow Outcome Scale | Severe TBI (GCS ≤ 8) | Very low |
Brown et al. [36] | G-EMS: time/distance vs mortality | G-EMS | B | Australia | O | Key exposure | 30 day mortality | Hospital LOS for 30 day survivors | PH total time > 60 min; prolonged time intervals in either response; on-scene; transport; total | Low |
Brown et al. [37] | Outcomes due to H-EMS vs G-EMS | Air | B | Australia | O | Key exposure | In-hospital mortality | - | H-EMS transport; time intervals | Low |
Brown et al. [37] | G-EMS: Time/distance vs mortality | Both | B | USA | O | Key exposure | In-hospital mortality | - | Total PH time > 20 min | Low |
Brown (2011) [38] | Outcomes due to H-EMS vs G-EMS | Both | B | USA | O | Covariate | Survival to hospital discharge | Hospital LOS; ICU admission; mechanical ventilation; emergent operations | Interfacility transfer of trauma patients HEMS and GEMS | Low |
Brown et al. [39] | Outcomes due to H-EMS vs G-EMS | Both | B | USA | O | Covariate | Survival to hospital discharge | Hospital resource utilization; ICU admission; mechanical ventilation | HEMS vs GEMS transport for trauma patients | Low |
Bulger et al. [40] | Outcomes due to H-EMS vs G-EMS | Both | B | USA | O | Key exposure | 24 h survival | Survival to 28 days; 6-month GOS | Transport modality; hypovolemic shock; severe TBI | Low |
Byrne et al. [41] | G-EMS: time/distance vs mortality | G-EMS | CU | USA | O | Key exposure | ED mortality | In-hospital mortality | PH time | Low |
Cardoso (2014) [42] | Miscellaneous | Air | B | Brazil | O | Covariate | In-hospital mortality | Hospital length of stay | HEMS transport for trauma | Low |
Chen (2014) [43] | Effect of PH intervention on outcomes | Both | CU | Taiwan | O | Covariate | Survival to hospital admission | Survival to hospital discharge | PH traumatic cardiac arrest with epinephrine administration | Low |
Chen (2018) [44] | Outcomes due to H-EMS vs G-EMS | Both | B | USA | O | Key exposure | In-hospital survival | - | H-EMS vs. GEMS transport | Low |
Chen et al. [45] | Time vs mortality | Both | B | USA | O | Key exposure | In-hospital mortality | - | PHT | Low |
Chen et al. [45] | Miscellaneous | Both | B | Taiwan | O | Covariate | ROSC in the ED | 30-day survival | Out of hospital traumatic cardiac arrest without PH ROSC | Low |
Chiang et al. [46] | Effect of PH intervention on outcomes | Both | CU | Taiwan | O | Covariate | Survival to hospital admission | Survival to hospital discharge | PH traumatic cardiac arrest with epinephrine administration | Low |
Chien (2016) [47] | Effect of PH intervention on outcomes | Both | B | Taiwan | O | Covariate | 24-h survival | Survival to hospital discharge; cerebral function at discharge | Traumatic cardiac arrest receiving PH CPR | Low |
Clark et al. [48] | Mortality due to rural vs urban | Both | B | USA | O | Covariate | In-hospital mortality | - | Trauma MVC | Low |
Clements et al. [49] | Time vs mortality | Both | B | Canada | O | Key exposure | In-hospital mortality | Association between PHT and trauma team activation | All cause blunt trauma injury; EMS transport | Low |
Crandall et al. [2] | Time vs mortality | Both | CU | USA | O | Outcome | In-hospital mortality | mean transport times | Gunshot victim > 5 miles from a trauma center | Low |
deJongh (2012) [50] | H-EMS: time vs mortality | Air | B | Netherlands | O | Key exposure | In-hospital mortality | - | H-EMS vs. G-EMS transport; total PH time | Low |
DeVloo (2018) [51] | Mortality due to primary vs secondary transfer | Both | CU | Belgium | O | Key exposure | 30-day mortality | - | Primary vs secondary transfer to tertiary center; total time to tertiary center ED; skin incision for craniotomy | Low |
Dinh et al. [15] | Time vs mortality | Both | B | Australia | O | Key exposure | In-hospital mortality | Survival to hospital discharge without requiring transfer for rehabilitation or nursing home care | Severe TBI (AIS ≥ 3); PH time | Low |
Fatovich et al. [52] | Mortality due to rural vs urban | Both | B | Australia | O | Key exposure | In-hospital mortality | Hospital LOS | Major trauma; rural vs urban associated PH times | Low |
Forristal (2018) [53] | Miscellaneous | Both | B | Canada | O | Covariate | Hypothermia (T < 35 °C) upon arrival to trauma center | Hospital LOS and survival to hospital discharge | EMS transport for severe trauma (ISS > 12) | Low |
Foster et al. [54] | Outcomes due to H-EMS vs G-EMS | Both | B | USA | O | Covariate | Neurologic deterioration | ED disposition; in-hospital mortality; inter-facility transfer time; hospital LOS; nonroutine discharge; radiographic evidence of worsening spinal cord injury. | Spine injury with interfacility transfer; H-EMS vs G-EMS | Low |
Franschman et al. [55] | Physiologic variables predicting outcomes in TBI | Both | B | Netherlands | O | Covariate | Neurologic deficit as determined by GOS | TBI-related mortality | TBI with transport to tertiary center; hypoxic or hypotensive events > 5 min during transport. | Low |
Fuller et al. [56] | Time vs mortality | Both | B | UK | O | Key exposure | 30-day inpatient mortality | - | EMS transport for severe TBI (AIS-head ≥ 3); EMS PHT intervals | Low |
Fuller et al. [57] | Physiologic variables predicting outcomes in TBI | Both | B | UK | O | Key exposure | In-hospital mortality | Vital sign deterioration | TBI with transport to tertiary center; PHT intervals | Low |
Funder et al. [58] | Time vs mortality | Both | CU | Denmark | O | Key exposure | 30-day mortality | - | Penetrating trauma by EMS to trauma center; PHT | Low |
Garcia (2017) [59] | Time vs mortality | G-EMS | CU | Canada | O | Key exposure | In-hospital mortality | - | Trauma with EMS transport to trauma center; PHT in intervals | Low |
Gauss et al. [19] | Time vs mortality | Both | B | France | O | Key exposure | In-hospital mortality | - | Physician-staffed EMS to trauma center; PHT in intervals | Low |
Gomes (2010) [60] | Effect of PH intervention on outcomes | Both | B | Portugal | O | Covariate | In-hospital mortality | - | Severe trauma requiring procedure; procedure done in PH; first hospital; arrival to trauma center | Low |
Haltmeier et al. [61] | Effect of PH intervention on outcomes | Both | B | USA | O | Outcome | In-hospital mortality | Ventilator days; length of ICU stay; on-scene; PH time | Isolated severe blunt head injury (PH GCS ≤ 8) with or without PH intubation | Low |
Hesselfeldt et al. [62] | H-EMS: mortality from physician vs paramedic | Air | B | Denmark | O | Outcome | Time from dispatch first ground EMS to arrival in the TC trauma bay | Proportion of severely injured patients secondarily transferred to the trauma center; 30-day mortality; on-scene triage. | Severe trauma patient transported by MD staffed H-EMS; PH fluid administration | Low |
Hussmann et al. [63] | Effect of PH intervention on outcomes | Both | B | Germany | O | Covariate | In-hospital mortality | Sepsis; organ failure; multiple organ failure | Trauma with bleeding requiring transfusion > 1 unit pRBCs in hospital; PH fluid administration | Moderate |
Hussmann et al. [64] | Effect of PH intervention on outcomes | Both | B | Germany | O | Covariate | In-hospital mortality | Hospital LOS; ICU LOS; ICU intubation; sepsis; organ failure; multi-organ failure | Level of PH fluid resuscitation of severe TBI patients | Low |
Ingalls et al. [65] | H-EMS: time vs mortality | Air | C | Multiple | O | Key exposure | 30-day mortality | Mortality en-route | Rapid evacuation by the Critical Care Air Transport (CCATT): time from wounding until time of arrival at the definitive care facility | Low |
Jung et al. [66] | H-EMS: mortality from physician vs paramedic | Air | CU | South Korea | O | Covariate | Survival | TRISS | Group P patients transported by physician-staffed HEMS and group NP patients were transported by nonphysician-staffed HEMS | Low |
Karrison (2018) [67] | G-EMS: time/distance vs mortality | G-EMS | CU | USA | O | Key exposure | ED/hospital mortality | None | Driving distance (shortest driving distance from the geocoded location of the scene of injury to the trauma center) transport time | Moderate |
Kidher et al. [68] | H-EMS: time vs mortality | Air | CU | England | O | Key exposure | Mortality | Time-related variables, stay on scene time, arrival on scene time, total scene time | Moderate | |
Kim et al. [69] | Effect of PH intervention on outcomes | Air | CR | USA | I | Covariate | Mortality (overall and 24-h mortality) | Hospital stay; ICU LOS; ARDS, ARF | PH plasma administration | Moderate |
Kim et al. [70] | G-EMS: time/distance vs mortality | G-EMS | Not specified | South Korea | O | Key exposure | In-hospital mortality | Scene time, PHT | Low | |
Klein (2019) [71] | Time vs mortality | Both | B | Multiple | O | Key exposure | Early SURG; ICU LOS; days intubated; organ failure; multiple organ failure; sepsis RISC prognosis; TRISS prognosis; in-hospital mortality; death within the first hour; death within the first 24 h; days of hospitalization | PH treatment time by intervals | Moderate | |
Kotwal et al. [72] | H-EMS: time vs mortality | Air | C | Afghanistan | O | Key exposure | Overall mortality, killed in action mortality, died of wound mortality | Amputation; cardiac arrest; coagulopathy; shock | Helicopter time < 60 min vs > 60 min | Moderate |
Kotwal et al. [73] | Time vs mortality | Both | C | Multiple | O | Key exposure | Mortality | PH transport time, injury severity, blood transfusion | Moderate | |
Kulla et al. [74] | Miscellaneous | Both | B | Germany | O | Outcome | Trauma resuscitation time prolongation | Invasive emergency procedures | Low | |
Lansom et al. [75] | Effect of PH intervention on outcomes | Both | B | Australia | O | Outcome | Survival | Reduction in time from ED arrival to CT imaging | PH intubation compared with ED intubation | Low |
Leis (2013) [76] | Effect of PH intervention on outcomes | G-EMS | CU | Spain | O | Key exposure | Survival to discharge | Response time | Low | |
Lovely et al. [77] | G-EMS: time/distance vs mortality | G-EMS | CR | USA | O | Key exposure | In-hospital mortality | PH scene time, PH transport time, Injury Severity Score (ISS) | Low | |
Lyon et al. [78] | Effect of PH intervention on outcomes | Air | B | England | I | Covariate | Mortality | ICU LOS | PRBC Transfusion | Low |
Maddry et al. [79] | H-EMS: time vs mortality | Both | C | Not specified | O | Key exposure | Mortality up to 30 days | Morbidity up to 30 days, ICU and hospital stay | Time from the initial request for medical evacuation to arrival at a medical treatment facility | Moderate |
Majidi et al. [80] | Physiologic variables predicting outcomes in TBI | Both | CU | USA | O | Covariate | Total hospital stay; in-hospital mortality; intensive care unit (ICU) days; ventilator days; discharge destinations | PH Neurologic Deterioration PHND | Moderate | |
Malekpour et al. [81] | Mortality due to primary vs secondary transfer | Both | CR | USA | O | Covariate | In-hospital mortality, ICU LOS, hospital LOS, complications | Pneumonia; pulmonary embolus; deep venous thrombosis; major arrhythmia, urinary tract infection, wound infection, acute renal failure | DA-direct admission IHT-Interhospital transfer | Moderate |
McCoy (2013) [82] | G-EMS: time/distance vs mortality | G-EMS | CU | USA | O | Key exposure | In-hospital mortality | EMS on-scene and transport time intervals | Moderate | |
Meizoso et al. [83] | Effect of PH intervention on outcomes | Both | CU | USA | O | Outcome | Mortality on arrival (or DOA) | Intubation, needle decompression, tourniquet use, cricothyroidotomy, or advanced cardiac life support | Low | |
Middleton (2012) [84] | Miscellaneous | Both | B | Australia | O | Key exposure | Short-term neurological recovery (as determined by patient’s ASIA impairment scale grade on discharge from SCIU) | Deep vein thrombosis; pulmonary embolism; pressure ulcers | Time to definitive care center SCIU | Low |
Möller et al. [20] | G-EMS: time/distance vs mortality | G-EMS | CU | South Africa | O | Key exposure | Mortality | Method of transport, hospital arrival time or PH transport time intervals | Low | |
Moore et al. [85] | Effect of PH intervention on outcomes | G-EMS | CU | USA | I | Outcome | Mortality | MOF at 28 days trauma-induced coagulopathy Shock Acute lung injury Exploratory outcomes: time from injury to need for first red blood cell transfusion Thromboelastography indices Number of ventilation free days Number of intensive-care-free days Development of MOF | Plasma administered in PH setting within 30 min of injury | High |
Murad et al. [86] | G-EMS: time/distance vs mortality | G-EMS | B | Iraq | O | Key exposure | Mortality | Physiologic Severity Score | Assess 2 tier PH system (first responder and paramedic) vs no EMS in patients with long PHTs | Low |
Murad et al. [87] | G-EMS: time/distance vs mortality | G-EMS | B | Iraq | O | Key exposure | Mortality | PH period intervals | Low | |
Neeki, et al. [88] | Effect of PH intervention on outcomes | Both | B | USA | I | Outcome | Mortality 24 h, 48 h, and 28 days | Total blood products transfused Hospital and ICU LOS, SBP prior to TXA administration, GCS prior to the first TXA dose in the field Adverse events | Prehospital TXA administration vs no TXA administration in patients with signs of h. shock | High |
Newberry (2019) [89] | Miscellaneous | G-EMS | CR | India | O | Covariate | Mortality at 2, 7, and 30 days | Oxygen delivery; Intravenous fluids; functional status | Transport by EMS if burn injury | Low |
Newgard et al. [90] | Outcomes due to H-EMS vs G-EMS | Both | B | Multiple | O | Key exposure | 28-day mortality in shock, 6-month neurologic function in TBI | Total out-of-hospital time (time of initial 9-1-1 call to time of EMS arrival at the receiving hospital ED) | Moderate | |
Newgard (2010) [91] | Outcomes due to H-EMS vs G-EMS | Both | B | Multiple | O | Key exposure | Mortality | EMS time intervals | Moderate | |
Pakkanen et al. [92] | G-EMS: mortality from physician vs paramedic | Both | B | Finland | O | Covariate | Mortality, neurological outcome of TBI patients | EMS physician-staffed, EMS paramedic-staffed | Low | |
Paravar (2014) [93] | G-EMS: time/distance vs mortality | G-EMS | B | Iran | O | Key exposure | Mortality (in-hospital) | PHT advanced trauma life support interventions | Low | |
Prabhakaran et al. [94] | Mortality due to primary vs secondary transfer | Both | CU | USA | O | Outcome | Mortality in TBI | Time to arrival at a level I trauma center; time to initiation of multimodality neurophysiological monitoring; goal-directed therapy protocol | Scene to hospital vs transfer to hospital | Low |
Pusateri et al. [95] | Effect of PH intervention on outcomes | Both | B | USA | I | Covariate | 28-day mortality | 24-h mortality; volumes of in-hospital blood components administered; ventilator-free days | PH transport times COMBAT Study pt. received plasma vs standard care PAMPer Study pt. received plasma vs standard care | Moderate |
Raatiniemi (2015) [96] | Mortality due to rural vs urban | Air | B | Finland | O | Covariate | 30-day mortality rate | Length of intensive care unit stay | Rural vs urban HEMS | Low |
Rappold et al. [97] | Miscellaneous | G-EMS | CU | USA | O | Covariate | Mortality in hospital | ALS-transported trauma victims relative to BLS-transported trauma victims and among police-transported trauma victims | Low | |
Reitz et al. [98] | Effect of PH intervention on outcomes | Both | B | USA | I | Outcome | 28-day mortality | 24-h mortality; PH transport time; presenting indices of shock and coagulopathy units of in-hospital blood components administered | COMBAT study pt. received plasma vs standard care PAMPer Study pt. received plasma vs standard care | Moderate |
Ruelas (2018) [99] | Time vs mortality | Both | B | USA | O | Key exposure | PH and ED mortality | PHT and procedures on penetrating trauma | Low | |
Ryb (2013) [100] | Outcomes due to H-EMS vs G-EMS | Both | B | USA | O | Covariate | Mortality | HEMS VS GEMS | Low | |
Seamon et al. [101] | Time vs mortality | CU | USA | O | Key exposure | Mortality | PHT prolonged by ALS vs BLS | Low | ||
Shackelford et al. [102] | Effect of PH intervention on outcomes | Air | C | Afghanistan | O | Key exposure | Mortality at 24 h and 30 days | Prevalence of shock | Initiation of PH transfusion RBC, plasma, or both | Moderate |
Spaite et al. [103] | Physiologic variables predicting outcomes in TBI | Both | CU | USA | O | Key exposure | Mortality in-hospital | Hypotension depth-duration out of hospital | Moderate | |
Talving (2009) [104] | Outcomes due to H-EMS vs G-EMS | Both | CU | USA | O | Covariate | Mortality | LOS; discharge time; ICU admission | HEMS vs. ground emergency medical service (GEMS) > 30 min | Low |
Tansley (2019) [105] | G-EMS: time/distance vs mortality | G-EMS | B | Canada | O | Key exposure | Mortality | PH transfer time to trauma center | Low | |
Taylor (2018) [106] | Outcomes due to H-EMS vs G-EMS | Both | B | USA | O | Covariate | Mortality | HEMS vs. ground emergency medical service (GEMS) | Low | |
Tien (2011) [107] | G-EMS: time/distance vs mortality | G-EMS | CU | Canada | O | Key exposure | Hospital survival | PHT Time-to-surgery | Low | |
Weichenthal (2015) [108] | Effect of PH intervention on outcomes | Both | B | USA | O | Covariate | Survival to hospital discharge | Needle thoracostomy VS No Needle Thoracostomy | Low | |
Yeguiayan et al. [109] | G-EMS: mortality from physician vs paramedic | G-EMS | CU | France | O | Covariate | 30-day mortality | 72-h mortality | Physician EMS vs non-Physician EMS | Low |
Zalstein (2010) [110] | Miscellaneous | Both | B | Australia | O | Covariate | Mortality | Adverse events | Patient inter-hospital transfer | Low |
Zhu (2019) [111] | Miscellaneous | Both | B | USA | O | Covariate | Survival, LOS, ICU days, ventilator days | Pt that required mass transfusion protocol | Low | |
Zhu (2018) [112] | Outcomes due to H-EMS vs G-EMS | Both | CR | USA | O | Covariate | Survival to discharge from hospital | HEMS v GEMS | Low |