Every minute counts: The impact of pre-hospital response time and scene time on mortality of penetrating trauma patients

Am J Surg. 2020 Jul;220(1):240-244. doi: 10.1016/j.amjsurg.2019.11.018. Epub 2019 Nov 16.


Background: Prompt surgical control of hemorrhage is crucial in penetrating trauma patients. We aimed to study the impact of prehospital response time (PreRespT) and scene time (SceneT) on hospital mortality.

Methods: Using the Trauma Quality Improvement Program (TQIP) 2010-2016 database, we identified all adults with penetrating injury. We defined PreRespT as time from EMS dispatch to scene arrival, and SceneT as time spent on scene. Univariate then multivariable logistic regression analyses were performed to study the independent correlation between PreRespT and SceneT on hospital mortality, adjusting for several covariates.

Results: Out of a total of 1,403,470 patients, 43,467 patients were included. Multivariable analyses suggested that: 1) every minute increase in PreRespT independently correlates with a 2% increase in mortality (OR 1.02, p < 0.0001), and 2) every minute increase in SceneT independently correlates with a 1% increase in mortality (OR 1.01, p = 0.001).

Conclusion: In the penetrating injury trauma patient, PreRespT and SceneT independently correlate with hospital mortality. This data suggests that a faster PreRespT and a "scoop and run" strategy may be more beneficial in this population.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Hospital Mortality / trends
  • Humans
  • Injury Severity Score
  • Male
  • Middle Aged
  • Retrospective Studies
  • Survival Rate / trends
  • Time Factors
  • Trauma Centers / statistics & numerical data*
  • United States / epidemiology
  • Wounds, Penetrating / diagnosis
  • Wounds, Penetrating / mortality*
  • Wounds, Penetrating / therapy
  • Young Adult