Title: Use of a Trauma Data Repository to Track Emergency Medical Service Transport Time and Hospital Disposition Authors:

Aman Banerjee MD1, Michael Nowak Ph.D1, Linda M. Quinn Ph.D2, Ariadni Papana Dagiasis Ph.D2, Jeffrey Claridge MD, MS, FACS1
1 2

Department of Surgery, MetroHealth Medical Center Campus, Cleveland, OH 44109, USA Department of Mathematics, Cleveland State University, Cleveland, OH 44115, USA

Introduction: Modern trauma systems coordinate the treatment of injured patients across multiple care settings. Access to reliable data across provider systems remains a major impediment in evaluating patient outcomes. Beginning in September of 2011 a trauma data repository was created wherein pre-hospital and hospital patient data was directly linked via the use of unique patient trauma ID band placed by emergency medical services (EMS). The following analysis demonstrates the use of the repository to evaluate pre-hospital performance metrics on patient outcomes, specifically admission to the hospital or discharge from the emergency department (ED). Methods: The trauma data repository was queried for all trauma patients transported to a regional level 1 trauma center by Cleveland EMS and Fire from January 2012 through June 2012. Pre-hospital data included city ward location, trauma type, and time to level 1 center. Hospital data included patient demographics, injury severity score (ISS), ED disposition (home or inpatient admission), total hospital length of stay (LOS) and hospital discharge disposition (home or facility/death). Results: There were 277 patients transported to the level 1 center during the study period. Table 1 summarizes the patient demographics and time to the level 1 trauma center which ranged from 1 minute 43 seconds to 31 minutes 51 seconds. Patients transported to the level 1 center in 10 minutes or less tended to have higher rates of discharge home from the ED but did not reach statistical significance. There was no difference in LOS or hospital discharge between groups.

Table 1
Demographics
n Median Age (IQR) % Male % Blunt Trauma Median ISS (IQR)
277 42 (27-55) 73 93 9 (4-16) 10:44 42

Performance Metric
Mean Time to Level 1 Center (Minutes) % Greater then 10 Minutes

Outcomes
Greater 10 Minutes than 10 or Less Minutes p-value Length of Stay (mean days) % Discharged Home from ER % Discharge Home From Hospital
5.4 64 89 6.3 53 85 0.7 0.09 0.4

Conclusion: The integrated trauma repository reliably links pre-hospital and hospital patient data. Transport times up to approximately 30 minutes to a level 1 trauma center are not associated with differences in hospital disposition or duration of hospital stay.