Format

Send to

Choose Destination
Am J Surg. 2020 Jan 22. pii: S0002-9610(20)30013-1. doi: 10.1016/j.amjsurg.2020.01.012. [Epub ahead of print]

Outcomes with advanced versus basic life support in blunt trauma.

Author information

1
Christiana Care Health System, 4755 Ogletown Stanton Rd, Suite 1320, Newark, DE, 19713, USA. Electronic address: mfarrellmd@gmail.com.
2
Christiana Care Health System, 4755 Ogletown Stanton Rd, Suite 1320, Newark, DE, 19713, USA. Electronic address: BenEmery@Udel.edu.
3
Christiana Care Health System, 4755 Ogletown Stanton Rd, Suite 1320, Newark, DE, 19713, USA. Electronic address: Richard.J.Caplan@christianacare.org.
4
Christiana Care Health System, 4755 Ogletown Stanton Rd, Suite 1320, Newark, DE, 19713, USA. Electronic address: JGetchell@christianacare.org.
5
Christiana Care Health System, 4755 Ogletown Stanton Rd, Suite 1320, Newark, DE, 19713, USA. Electronic address: MCipolle@christianacare.org.
6
Christiana Care Health System, 4755 Ogletown Stanton Rd, Suite 1320, Newark, DE, 19713, USA. Electronic address: Kbradley@christianacare.org.

Abstract

INTRODUCTION:

The role of advanced life support (ALS) versus basic life support (BLS) in blunt trauma is controversial. Previous studies have shown no mortality benefit with ALS for penetrating trauma but the blunt population has mostly remained unaddressed.

METHODS:

A retrospective cohort study was conducted at a Level 1 trauma center comparing outcomes in blunt trauma patients managed by ALS versus BLS from July 1, 2014 to December 31, 2014. Both Injury Severity Score (ISS) and select Abbreviated Injury Score (AIS) were used to determine differences in mortality, length of stay (LOS) and complications based on mode of transportation, prehospital time, and number of prehospital interventions.

RESULTS:

698 total patients were identified. Mortality and complications were grossly higher in ALS patients (p = 0.01 and < 0.001, respectively). When accounting for ISS and AIS there was no difference in mortality (p=<0.001-0.003). Prehospital interventions did not increase prehospital time (p = 0.7) but did correlate with increased mortality (p < 0.001).

CONCLUSION:

There is no mortality advantage for blunt trauma patients managed by ALS versus BLS.

KEYWORDS:

Abbreviated injury score; Blunt trauma; Emergency medical system; Injury severity score; Prehospital emergency care; Trauma; Trauma severity indices; Trauma systems

Conflict of interest statement

Declaration of competing interest None of the authors have any conflicts of interest related to this project. Two authors were supported by institutional grants which were not directly related to the work presented here. Dr. Richard Caplan is supported by the National Institute of Health Grant number U54-GM104941. Mr. Benjamin Emery is supported by the National Institute of Health Grant number P20 GM103446 (NIGMS).

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center