Author:
Sung Chih-Wei,Sun Jen-Tang,Huang Edward Pei-Chuan,Shin Sang Do,Song Kyoung Jun,Hong Ki Jeong,Jamaluddin Sabariah Faizah,Son Do Ngoc,Hsieh Ming-Ju,Ma Matthew Huei-Ming,Hsu Li-Min,Chiang Wen-Chu,Rao Ramana,Abraham George P.,Ramakrishnan T. V.,Jamaluddin Sabariah Faiwah,Mohidin Mohd Amin Bin,Saim Al-Hilmi,Kean Lim Chee,Anthonysamy Cecilia,Yssof Shah Jahan Din Mohd,Ji Kang Wen,Kheng Cheah Phee,Ali Shamila Bt Mohamad,Ramanathan Periyanayaki,Yang Chia Boon,Chia Hon Woei,Hamad Hafidahwati Binti,Ismail Samsu Ambia,Abdullah Wan Rasydan B. Wan,Tanaka Hideharu,Kimura Akio,Velasco Bernadett,Gundran Carlos D.,Convocar Pauline,Sabarre Nerissa G.,Tiglao Patrick Joseph,Hong Ki Jeong,Song Kyoung Jun,Jeong Joo,Moon Sung Woo,Kim Joo-yeong,Cha Won Chul,Lee Seung Chul,Ahn Jae Yun,Lee Kang Hyeon,Yeom Seok Ran,Ryu Hyeon Ho,Kim Su Jin,Kim Sang Chul,Hu Ray-Heng,Sun Jen Tang,Wang Ruei-Fang,Hsieh Shang-Lin,Kao Wei-Fong,Riyapan Sattha,Tianwibool Parinya,Buaprasert Phudit,Akaraborworn Osaree,Sakaf Omer Ahmed Al,Fares Saleh,Huy Le Bao,Son Do Ngoc,Van Dai Nguyen,
Abstract
AbstractPrehospital fluid resuscitation with crystalloids in patients following trauma remain controversial. This study aimed to investigate the association between prehospital fluid resuscitation and outcomes of trauma patients in Asia. We conducted a retrospective cohort study of trauma patients between 2016 and 2018 using data from the Pan-Asia Trauma Outcomes Study (PATOS) database. Prehospital fluid resuscitation was defined as any administration of intravenous crystalloid fluid on the ambulance before arrival to hospitals. The outcomes were in-hospital mortality and poor functional outcomes, defined as Modified Rankin Scale ≥ 4. Propensity score matching (PSM) was used to equalize potential prognostic factors in both groups. This study included 31,735 patients from six countries in Asia, and 4318 (13.6%) patients had ever received prehospital fluid resuscitation. The patients receiving prehospital fluid resuscitation had a higher risk of in-hospital mortality, with an adjusted odds ratio (aOR) of 2.02, 95% confidence interval (CI) 1.32–3.10, p = 0.001 in PSM analysis. Prehospital fluid resuscitation was also associated with poor functional outcomes, with an OR 1.73, 95% CI: 1.48–2.03, p < 0.001 in PSM analysis. Prehospital fluid resuscitation in patients with major trauma (injury severity score ≥ 16) presented a higher risk of poor functional outcomes (aOR = 2.65, 95% CI: 1.89–3.73 in PSM analysis, pinteraction = 0.006) via subgroup analysis. Prehospital fluid resuscitation of trauma patients is associated with higher in-hospital mortality and poor functional outcomes in the subgroup in countries studied.
Funder
Ministry of Science and Technology
Publisher
Springer Science and Business Media LLC