Services on Demand
Journal
Article
Indicators
Cited by SciELO
Access statistics
Related links
Cited by Google
Similars in SciELO
Similars in Google
Share
Revista Colombiana de Cirugía
Print version ISSN 2011-7582On-line version ISSN 2619-6107
Abstract
SERNA, Carlos A. et al. From a Trauma Center to a Trauma System in Southwest Colombia. rev. colomb. cir. [online]. 2023, vol.38, n.1, pp.128-144. Epub Dec 06, 2022. ISSN 2011-7582. https://doi.org/10.30944/20117582.2287.
Introduction.
This study aims to evaluate the impact on mortality by admission profile to a trauma center in Southwest Colombia between direct and referred patients, as a method to understand the dynamics of trauma care.
Methods.
A sub-analysis of the Panamerican Trauma Society registry associated with a trauma center in Southwest Colombia was performed. Patients attended between 2012-2021 were analyzed. Patients with direct admission and referred condition were compared. Analyses of populations of interest such as patients with severe trauma (ISS > 15) and patients with/without brain trauma were made. The impact of referred patients and their admission status on mortality was evaluated.
Results.
A total of 10,814 patients were included. The proportion of referred patients was 54.7%. Patients admitted referred vs. with direct admission have differences regarding trauma severity and physiological compromise on admission. The referred patient has a higher risk of mortality (RR: 2.81; 95% CI 2.44-3.22). There is a high proportion of penetrating trauma by gunshot wounds. However, it is the physiological state at admission that impacts mortality.
Conclusion.
Patients referred from other institutions have a higher mortality risk, being a health inequity that invites the articulation of institutional actors in trauma care. A trauma center should relate to partner institutions to create a trauma system that optimizes care and timeliness.
Keywords : trauma centers; prehospital care; referral and consultation; wounds and injuries; trauma severity score; advanced trauma life support care.