Association between prehospital time and outcome of trauma patients in 4 Asian countries: A cross-national, multicenter cohort study
Released on October 6th, 2020, this study, entitled Association between prehospital time and outcome of trauma patients in 4 Asian countries: A cross-national, multicenter cohort study looked at trauma cases from January 1st, 2016 to November 30th, 2018. In total, the research considered 24,365 patients from 4 countries (645 patients from Japan, 16,476 patients from Korea, 5,358 patients from Malaysia, and 1,886 patients from Taiwan).
In particular, this study aimed to substantiate the concept of the “golden hour of treatment” in medical care.
The Golden Hour of Treatment
In general, the “Golden Hour of Treatment” refers to the period of time immediately following a serious trauma in which there is the highest likelihood that prompt medical treatment will prevent death or other serious injury. While the term “hour” is used in the title, the exact amount of time can vary based on type of trauma at issue. However, the point is clear, the faster you get treatment after an injury – the better the health outcomes.
The term, Golden Hour of Treatment, is often attributed to R. Adams Cowley – the Founder of the Shock Trauma Institute. In a 1975 article, he explained that:
The first hour after injury will largely determine a critically-injured person’s chances for survival.
What the Study Found
Many scholars have long wondered whether the Golden Hour of Treatment was mere medical folklore. Studies since 1975 have lended credibility to the idea – but the exact impact of delayed treatment has often been a matter of conjecture. In fact, this recent study acknowledged that “studies have shown divergence in the association between prehospital time and mortality in injured patients.”
Thus, the researched conducted a 3 year, multi-center cohort study that included 24,365 patients in 4 countries. Interestingly, the study found some interesting points:
- There was no association between prehospital time and 30-day mortality in trauma patients overall
- longer prehospital time was detrimental to functional outcome
- Every 10-minute delay in total prehospital time was associated with a 6% increase in the odds of a poor functional outcome (Poor functional outcome indicates severe disability in daily life, or death).
What Does This Mean?
As an overarching point, the study makes clear what we have known as personal injury lawyer for some time – trauma patients that delay in seeking treatment are more likely to suffer poorer functional outcomes, such as severe disabilities in daily life.
The causes of these delays in treatment were also found to be multi-factored. In the study, the researchers identified the following causes of medical treatment delay:
- Response Time; and
- Scene Control; and
- Extrication; and
- Interventions; and
- Transportation to Hospital.
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