• P A Kearney, L Terry, and R E Burney.
• Department of Surgery, University of Kentucky Medical Center, Lexington.
• Ann Emerg Med. 1991 Aug 1;20(8):882-6.

Study ObjectiveThis study was conducted to assess the outcome of patients suffering multiple injuries from blunt trauma who were transferred to a Level I trauma center for definitive care after special diagnostic or treatment procedures (DTPs) or after a simple delay of four hours at a primary receiving hospital.DesignRetrospective review of aeromedical registry data and clinical chart review.MeasurementsAeromedical trauma transfers made during a four-year period were studied. The TRISS method was used to determine predicted survivals for DTP patients, patients transferred after a four-hour delay, and patients transferred promptly.ResultsThe observed survival for 469 aeromedically transferred patients with blunt trauma was the same as that predicted by TRISS analysis (394 vs 392.5). Survival for 86 patients with DTP was also the same as predicted (62 vs 61.6). Outcomes for nonDTP patients and for 92 patients experiencing a delay in transport of four hours or more were also the same as predicted.ConclusionEarly versus delayed decision to transfer patients with blunt trauma did not appear to influence overall outcome. These data suggest that minor delays in recognizing the need to transfer patients with blunt injuries to a trauma center for definitive care may be offset by rapid, skilled transfer and highly specialized trauma care and support the hypothesis that regional trauma center care after initial evaluation and resuscitation elsewhere can be effective even when the timing of transfer is not ideal.

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