Impact of on-site care, prehospital time, and level of in-hospital care on survival in severely injured patients

J Trauma. 1993 Feb;34(2):252-61. doi: 10.1097/00005373-199302000-00014.


A sample of 360 severely injured patients was selected from a cohort of 8007 trauma victims followed prospectively from the time of injury to death or discharge. A case referent study was used to test the association between on-site care, total prehospital time, and level of care at the receiving hospital with short-term survival. Multiple logistic regression analyses showed that use of Advanced Life Support (ALS) at the scene was not associated with survival, whereas treatment at a level I compatible hospital was associated with a 38% reduction in the odds of dying, which approached statistical significance. Total prehospital time over 60 minutes was associated with a statistically significant adjusted relative odds of dying (OR = 3.0). The results of this study support the need for regionalization of trauma care and fail to show a benefit associated with ALS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Cohort Studies
  • Emergency Medical Services*
  • Emergency Medical Technicians
  • Female
  • Hospitalization*
  • Humans
  • Life Support Care
  • Male
  • Odds Ratio
  • Prospective Studies
  • Quebec / epidemiology
  • Regression Analysis
  • Risk
  • Survival Analysis
  • Wounds and Injuries / mortality*
  • Wounds and Injuries / therapy*