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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