• Shang-Lin Hsieh, Chien-Han Hsiao, Wen-Chu Chiang, Sang Do Shin, Sabariah Faizah Jamaluddin, Do Ngoc Son, Ki Jeong Hong, Sun Jen-Tang, Weide Tsai, Ding-Kuo Chien, Wen-Han Chang, Tse-Hao Chen, and PATOS Clinical Research Network.
• Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
• Eur J Trauma Emerg Surg. 2022 Aug 1; 48 (4): 2709-2716.

PurposeThis study examined the association between lapsed time and trauma patients, suggesting that a shorter time to definitive care leads to a better outcome.MethodsWe used the Pan-Asian Trauma Outcome Study registry to analyze a retrospective cohort of 963 trauma patients who received surgical intervention or transarterial embolization within 2 h of injury in Asian countries between January 2016 and December 2020. Exposure measurement was recorded every 30 min from injury to definitive care. The 30 day mortality rate and functional outcome were studied using the Modified Rankin Scale ratings of 0-3 vs 4-6 for favorable vs poor functional outcomes, respectively. Subgroup analyses of different injury severities and patterns were performed.ResultsThe mean time from injury to definitive care was 1.28 ± 0.69 h, with cases categorized into the following subgroups: < 30, 30-60, 60-90, and 90-120 min. For all patients, a longer interval was positively associated with the 30 day mortality rate (p = 0.053) and poor functional outcome (p < 0.05). Subgroup analyses showed the same association in the major trauma (n = 321, p < 0.05) and torso injury groups (n = 388, p < 0.01) with the 30 day mortality rate and in the major trauma (p < 0.01), traumatic brain injury (n = 741, p < 0.05), and torso injury (p < 0.05) groups with the poor functional outcome.ConclusionEven within 2 h, a shorter time to definitive care is positively associated with patient survival and functional outcome, especially in the subgroups of major trauma and torso injury.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.

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