Epidemiology of patients assessed for trauma by Swedish ambulance services: a retrospective registry study
Abstract Background There is a lack of knowledge regarding the epidemiology of severe trauma assessed by Swedish emergency medical services (EMS). Aim To investigate the prevalence of trauma in Sweden assessed by EMS from a national perspective and describe patient demography, aetiology, trauma type...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Emergency Medicine |
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| Online Access: | https://doi.org/10.1186/s12873-023-00924-5 |
| _version_ | 1827382444923289600 |
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| author | Glenn Larsson Christer Axelsson Magnus Andersson Hagiwara Johan Herlitz Håkan Klementsson Thomas Troëng Carl Magnusson |
| author_facet | Glenn Larsson Christer Axelsson Magnus Andersson Hagiwara Johan Herlitz Håkan Klementsson Thomas Troëng Carl Magnusson |
| author_sort | Glenn Larsson |
| collection | DOAJ |
| description | Abstract Background There is a lack of knowledge regarding the epidemiology of severe trauma assessed by Swedish emergency medical services (EMS). Aim To investigate the prevalence of trauma in Sweden assessed by EMS from a national perspective and describe patient demography, aetiology, trauma type, prehospital triage and clinical outcomes. Methods Data from two national quality registries, the Swedish Ambulance Registry and the Swedish Trauma Registry (SweTrau) were collected from January 1 to December 31, 2019. Inclusion criteria were an Emergency Symptoms and Signs code equivalent to trauma in the Swedish Ambulance Registry and criteria fulfilled for SweTrau inclusion. Exclusion criteria were patients < 18 years old, those not transported to a hospital and those without a personal identification number. Results In total, 53,120 patients with trauma were included (14% of primary EMS missions involving a personal identification number). Of those, 2,278 (4.3%) patients (median age: 45 years; 32% women) were reported in SweTrau to have severe or potentially severe trauma (penetrating: 7%, blunt: 93%). In terms of including all causes of trauma, the code for ‘trauma alert activation’ was most frequent (55%). The most frequent injury mechanism was an injury caused by a car (34%). Most (89%) cases were assigned Priority 1 (life-threatening condition) at the dispatch centre. 62% were regarded as potentially life threatening upon EMS arrival, whereas 29% were assessed as non-life-threatening. Overall, 25% of the patients had new injury severity scores > 15. 12% required invasive treatment, 11% were discharged with severe disability and the 30-day mortality rate was 3.6%. Conclusion In this cross-sectional study, 14% of the primary EMS missions for one year were caused by trauma. However, only a small proportion of these cases are severe injuries, and the risk of severe disabilities and death appears to be limited. The most frequent aetiology of a severe trauma is injury caused by a car, and most severe traumas are blunt. Severe traumas are given the highest priority at the dispatch centre in the vast majority of cases, but nearly one-third of these cases are considered a low priority by the EMS nurse. The latter leaves room for improvement. |
| first_indexed | 2024-03-08T14:19:43Z |
| format | Article |
| id | doaj.art-f83a42558644471a9b68b17011e034e2 |
| institution | Directory Open Access Journal |
| issn | 1471-227X |
| language | English |
| last_indexed | 2024-03-08T14:19:43Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Emergency Medicine |
| spelling | doaj.art-f83a42558644471a9b68b17011e034e22024-01-14T12:14:07ZengBMCBMC Emergency Medicine1471-227X2024-01-012411910.1186/s12873-023-00924-5Epidemiology of patients assessed for trauma by Swedish ambulance services: a retrospective registry studyGlenn Larsson0Christer Axelsson1Magnus Andersson Hagiwara2Johan Herlitz3Håkan Klementsson4Thomas Troëng5Carl Magnusson6PreHospen-Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of BoråsPreHospen-Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of BoråsPreHospen-Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of BoråsPreHospen-Centre for Prehospital Research, Faculty of Caring Science, Work Life and Social Welfare, University of BoråsRegister Centre SouthRegister Centre SouthDepartment of Prehospital Emergency Care, Sahlgrenska University HospitalAbstract Background There is a lack of knowledge regarding the epidemiology of severe trauma assessed by Swedish emergency medical services (EMS). Aim To investigate the prevalence of trauma in Sweden assessed by EMS from a national perspective and describe patient demography, aetiology, trauma type, prehospital triage and clinical outcomes. Methods Data from two national quality registries, the Swedish Ambulance Registry and the Swedish Trauma Registry (SweTrau) were collected from January 1 to December 31, 2019. Inclusion criteria were an Emergency Symptoms and Signs code equivalent to trauma in the Swedish Ambulance Registry and criteria fulfilled for SweTrau inclusion. Exclusion criteria were patients < 18 years old, those not transported to a hospital and those without a personal identification number. Results In total, 53,120 patients with trauma were included (14% of primary EMS missions involving a personal identification number). Of those, 2,278 (4.3%) patients (median age: 45 years; 32% women) were reported in SweTrau to have severe or potentially severe trauma (penetrating: 7%, blunt: 93%). In terms of including all causes of trauma, the code for ‘trauma alert activation’ was most frequent (55%). The most frequent injury mechanism was an injury caused by a car (34%). Most (89%) cases were assigned Priority 1 (life-threatening condition) at the dispatch centre. 62% were regarded as potentially life threatening upon EMS arrival, whereas 29% were assessed as non-life-threatening. Overall, 25% of the patients had new injury severity scores > 15. 12% required invasive treatment, 11% were discharged with severe disability and the 30-day mortality rate was 3.6%. Conclusion In this cross-sectional study, 14% of the primary EMS missions for one year were caused by trauma. However, only a small proportion of these cases are severe injuries, and the risk of severe disabilities and death appears to be limited. The most frequent aetiology of a severe trauma is injury caused by a car, and most severe traumas are blunt. Severe traumas are given the highest priority at the dispatch centre in the vast majority of cases, but nearly one-third of these cases are considered a low priority by the EMS nurse. The latter leaves room for improvement.https://doi.org/10.1186/s12873-023-00924-5TraumaInjuryEmergency medical servicesAmbulance servicesPatientSeverity |
| spellingShingle | Glenn Larsson Christer Axelsson Magnus Andersson Hagiwara Johan Herlitz Håkan Klementsson Thomas Troëng Carl Magnusson Epidemiology of patients assessed for trauma by Swedish ambulance services: a retrospective registry study BMC Emergency Medicine Trauma Injury Emergency medical services Ambulance services Patient Severity |
| title | Epidemiology of patients assessed for trauma by Swedish ambulance services: a retrospective registry study |
| title_full | Epidemiology of patients assessed for trauma by Swedish ambulance services: a retrospective registry study |
| title_fullStr | Epidemiology of patients assessed for trauma by Swedish ambulance services: a retrospective registry study |
| title_full_unstemmed | Epidemiology of patients assessed for trauma by Swedish ambulance services: a retrospective registry study |
| title_short | Epidemiology of patients assessed for trauma by Swedish ambulance services: a retrospective registry study |
| title_sort | epidemiology of patients assessed for trauma by swedish ambulance services a retrospective registry study |
| topic | Trauma Injury Emergency medical services Ambulance services Patient Severity |
| url | https://doi.org/10.1186/s12873-023-00924-5 |
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