Comparing Outcomes between Major Trauma Patients Transferred from a Different Hospital and Patients Transported Directly to Trauma Centers: A Retrospective Analysis with Propensity Score Matching Analysis

Abstract

This study aimed to explore differences in outcomes between these major trauma patients who were transferred and those directly transported to trauma centers. The medical information and outcome of 5,341 major trauma patients with an injury severity score (ISS) ≥ 16 who were hospitalized for treatment between January 1, 2009, and December 31, 2019, were collected from the Trauma Registry System of the hospital. There were 2,386 patients who were transferred (transfer group) and 2,955 patients transported directly to trauma centers first (direct group). Regarding the outcomes, there was no significant difference in the mortality rate between patients in the transfer group and the direct group (11.1% vs. 10.5%, respectively, $p=0.527$ ). However, the patients in the transfer group had a longer hospital stay (16.8 days vs. 14.3 days, respectively, $p<0.001$ ) and higher incidence of intensive care unit (ICU) admission (74.9% vs. 70.5%, respectively, $p<0.001$ ) than those patients in the direct group. Similar results were observed in the selected 2,139 pairs of propensity score-matched patient populations, who did not present with significant differences in sex, age, comorbidities, trauma mechanisms, and ISS. This study revealed no significant difference in the mortality rate between the two groups of major trauma patients. However, the transferred patients had significantly longer hospital stays and higher rates of ICU admission than patients directly transported to trauma centers.