ArticleCritical care (London, England)2011
Medical pre-hospital management reduces mortality in severe blunt trauma: a prospective epidemiological study.
Article in Critical care (London, England), 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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Who cites it
25 citing papers in PubMed.
- Impact of the emergency medical services crew size (2 vs. ≥3 personnel) on prehospital performance and survival in severe trauma: a nationwide cohort study in Korea.Journal of trauma and injury · 2026Article
- Emergency critical care: closing the gap between onset of critical illness and intensive care unit admission.Wiener klinische Wochenschrift · 2024Review
- Impact of physician-staffed ground emergency medical services-administered pre-hospital trauma care on in-hospital survival outcomes in Japan.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Factors Associated with 24-Hour Clinical Outcome of Emergency Patients; a Cohort Study.Archives of academic emergency medicine · 2022Article
- Physician-led prehospital management is associated with reduced mortality in severe blunt trauma patients: a retrospective analysis of the Japanese nationwide trauma registry.Scandinavian journal of trauma, resuscitation and emergency medicine · 2021Article
- Survival Rates and Factors Related to the Survival of Traffic Accident Patients Transported by Emergency Medical Services.Open access emergency medicine : OAEM · 2021Article
- Article
- Evaluation of a Prehospital Rotation by Senior Residents: A Web-Based Survey.Healthcare (Basel, Switzerland) · 2020Article
- A scoping review of worldwide studies evaluating the effects of prehospital time on trauma outcomes.International journal of emergency medicine · 2020Article
- The ticking clock: does actively making an enhanced care team aware of the passage of time improve pre-hospital scene time following traumatic incidents?Scandinavian journal of trauma, resuscitation and emergency medicine · 2020Article
- Association of Prehospital Time to In-Hospital Trauma Mortality in a Physician-Staffed Emergency Medicine System.JAMA surgery · 2019Observational
- Article
- Development and validation of a pre-hospital "Red Flag" alert for activation of intra-hospital haemorrhage control response in blunt trauma.Critical care (London, England) · 2018Article
- The Quality of Pre-hospital Circulatory Management in Patients With Multiple Trauma Referred to the Trauma Center of Shahid Beheshti Hospital in Kashan, Iran, in the First Six Months of 2013.Nursing and midwifery studies · 2016Article
- Alcohol exposure, injury, and death in trauma patients.The journal of trauma and acute care surgery · 2015Article
- A regional trauma system to optimize the pre-hospital triage of trauma patients.Critical care (London, England) · 2015Article
- [Deployment and efficacy of ground versus helicopter emergency service for severely injured patients. Analysis of a nationwide Swiss trauma center].Der Unfallchirurg · 2015Article
- Ultrasound assessment of gastric volume in critically ill patients.Intensive care medicine · 2014Observational
- Epidemiology of patients with multiple trauma and the quality of their prehospital respiration management in kashan, iran: six months assessment.Archives of trauma research · 2014Article
- The quality of pre-hospital oxygen therapy in patients with multiple trauma: a cross-sectional study.Iranian Red Crescent medical journal · 2014Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSevere blunt trauma is a leading cause of premature death and handicap. However, the benefit for the patient of pre-hospital management by emergency physicians remains controversial because it may delay admission to hospital. This study aimed to compare the impact of medical pre-hospital management performed by SMUR (Service Mobile d'Urgences et de Réanimation) with non-medical pre-hospital management provided by fire brigades (non-SMUR) on 30-day mortality.
methodsThe FIRST (French Intensive care Recorded in Severe Trauma) study is a multicenter cohort study on consecutive patients with severe blunt trauma requiring admission to university hospital intensive care units within the first 72 hours. Initial clinical status, pre-hospital life-sustaining treatments and Injury Severity Scores (ISS) were recorded. The main endpoint was 30-day mortality.
resultsAmong 2,703 patients, 2,513 received medical pre-hospital management from SMUR, and 190 received basic pre-hospital management provided by fire brigades. SMUR patients presented a poorer initial clinical status and higher ISS and were admitted to hospital after a longer delay than non-SMUR patients. The crude 30-day mortality rate was comparable for SMUR and non-SMUR patients (17% and 15% respectively; P = 0.61). After adjustment for initial clinical status and ISS, SMUR care significantly reduced the risk of 30-day mortality (odds ratio (OR): 0.55, 95% CI: 0.32 to 0.94, P = 0.03). Further adjustments for the delay to hospital admission only marginally affected these results.
conclusionsThis study suggests that SMUR management is associated with a significant reduction in 30-day mortality. The role of careful medical assessment and intensive pre-hospital life-sustaining treatments needs to be assessed in further studies.
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