Effects of Time of Arrival on Trauma Patient Outcomes

Document Type

Article

Publication Date

4-22-2024

Abstract

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Abstract

Background

Arriving during “off hours” to the hospital can put patients at greater risk of complications or mortality given lesser staff. Our goal was to investigate this in trauma patients with an Injury Severity Score (ISS) of >15. We hypothesized that the patients admitted late at night and/or during the weekend, would have worse outcomes, delays to the operating room (OR), and longer lengths of stay (LOS) compared to those who arrive on a weekday during the day.

Methods

We performed a retrospective study from 8/1/2019 to 8/1/2022 of all trauma patients with an ISS >15 at our Level 1 Trauma Center. Patients < 18 years, dead on arrival, or transferred out were excluded. Univariate and multivariable analysis were performed comparing weekday vs weekend arrivals, day vs night shift arrivals, and with patients grouped as weekday day, weekday night, weekend day, and weekend night. The primary outcome was mortality.

Results

953 patients met inclusion criteria. The patients that arrived on the weekend and at night were significantly younger than their counterparts. A significantly greater percentage of Black patients arrived during night shift. Mortality, hospital LOS, and ICU LOS did not differ based on day or time of arrival.

Conclusion

Contrary to our hypothesis, our study did not find a significant difference in outcomes when evaluating based on a patient’s time of arrival. This gives credence that our mature trauma center can provide the same level of care despite the time of a severely injured patient’s time of arrival.

Comments

This article was published in American Surgeron, Volume 90, Issue 9, pages 2188 - 2193.

The published version is available at https://doi.org/10.1177/00031348241248694.

Copyright © 2024 The Author(s).

Publication Title

American Surgeon

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