C. E. Sharoky2, E. J. Kaufman2, S. F. Jacoby2, P. M. Reilly2, D. N. Holena2 2Hospital Of The University Of Pennsylvania,Traumatology, Surgical Critical Care And Emergency Surgery,Philadelphia, PA, USA
Introduction: Police transport (PT) of penetrating trauma patients has been promoted as a method of decreasing pre-hospital times for patients with life-threatening hemorrhage, and is part of police policy in Philadelphia. We hypothesized that bluntly injured patients would also undergo PT, particularly if injured by MVC or assault, and that outcomes would be worse for PT vs. ambulance transport.
Methods: We used Pennsylvania Trauma Outcomes Study registry data from 2006-2015 to identify bluntly injured adult patients transported to all 8 trauma centers in Philadelphia. PT was compared to ambulance transport, excluding transfers, burn patients, and private transport. We compared demographics, mechanism, and injury outcomes between PT and ambulance transport patients. We used multivariable logistic regression to identify independent predictors of PT.
Results: Of 30,501 bluntly injured patients, 327 (1.1%) were transported by police and 29,903 (98.9%) by ambulance. PT patients were younger, more often male (83.5 vs. 62.3%, p <0.001), and black (56.7 vs. 37.1%, p < 0.001). More PT patients were injured by assault, and fewer were injured at home. PT patients had lower mortality (2.1 vs. 6.1%). Of PT patients, 9.8% had spine injuries, and 40.1% had head injuries (AIS ≥ 2). PT patients were more often discharged to jail (32.8 vs. 1.4%). In multivariable logistic regression, black race was associated with increased odds of PT. Age ≥ 50 was protective, as was female sex and Injury Severity Score ≥ 9. Compared to fall, all other mechanisms were associated with increased odds of PT, particularly assault (Table 1).
Conclusion: PT affects a small minority of blunt trauma patients, and did not appear associated with worse outcomes. However, PT patients included many who could have benefited from proven, pre-hospital interventions such as supplemental oxygen for brain injury or spine stabilization. Further research is needed to understand the indications for PT within the trauma care system and the impact of PT on patients.
