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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.