Observational studyBJS open2020
Time to definitive care within major trauma networks in England.
Observational study in BJS open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Transport and destination hospital for patients with suspected multiple and/or severe injuries - a systematic review and clinical practice guideline update.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Pooled it
- Guidelines for Enhanced Recovery After Trauma and Intensive Care (ERATIC): Enhanced Recovery After Surgery (ERAS) and International Association for Trauma Surgery and Intensive Care (IATSIC) Society Recommendations: Part 3: Trauma Ethics and Systems Aspects.World journal of surgery · 2025Guideline
- Cost-effectiveness of immediate total-body CT in patients with severe trauma (REACT-2 trial).The British journal of surgery · 2021Trial
- The Impact of Indirect Transport to a Trauma Centre on Survival for Major Trauma Patients: A National Propensity-Adjusted Observational Study.International journal of population data science · 2026Observational
- Article
- Factors associated with a positive shock index in the prehospital setting after major trauma.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Helicopter emergency medical services demonstrate reduced time to emergency anaesthesia in an undifferentiated trauma population: a retrospective observational analysis across three major trauma networks.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Observational
- Association between Time to Emergent Surgery and Outcomes in Trauma Patients: A 10-Year Multicenter Study.Medicina (Kaunas, Lithuania) · 2024Article
- The Patterns and Quality of Acute Trauma Care in A University Hospital - A 5-year Analysis.Medical archives (Sarajevo, Bosnia and Herzegovina) · 2024Article
- Do direct admissions to trauma centers have a survival benefit compared to inter-hospital transfers in severe trauma?European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- Article
- Improvements over time for patients following liver trauma: A 17-year observational study.Frontiers in surgery · 2023Article
- Variation in timely surgery for severe open tibial fractures by time and place of presentation in England from 2012 to 2019 : a cohort study using data collected nationally by the Trauma Audit and Research Network.Bone & joint open · 2022Article
- Comparing Outcomes between Major Trauma Patients Transferred from a Different Hospital and Patients Transported Directly to Trauma Centers: A Retrospective Analysis with Propensity Score Matching Analysis.Emergency medicine international · 2022Article
- A Systematic Literature Review of Trauma Systems: An Operations Management Perspective.Advances in rehabilitation science and practiceReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSignificant mortality improvements have been reported following the implementation of English trauma networks. Timely transfer of seriously injured patients to definitive care is a key indicator of trauma network performance. This study evaluated timelines from emergency service (EMS) activation to definitive care between 2013 and 2016.
methodsAn observational study was conducted on data collected from the UK national clinical audit of major trauma care of patients with an Injury Severity Score above 15. Outcomes included time from EMS activation to: arrival at a trauma unit (TU) or major trauma centre (MTC); to CT; to urgent surgery; and to death.
resultsSecondary transfer was associated with increased time to urgent surgery (median 7·23 (i.q.r. 5·48-9·28) h versus 4·37 (3·00-6·57) h for direct transfer to MTC; P < 0·001) and an increased crude mortality rate (19·6 (95 per cent c.i. 16·9 to 22·3) versus 15·7 (14·7 to 16·7) per cent respectively). CT and urgent surgery were performed more quickly in MTCs than in TUs (2·00 (i.q.r. 1·55-2·73) versus 3·15 (2·17-4·63) h and 4·37 (3·00-6·57) versus 5·37 (3·50-7·65) h respectively; P < 0·001). Transfer time and time to CT increased between 2013 and 2016 (P < 0·001). Transfer time, time to CT, and time to urgent surgery varied significantly between regional networks (P < 0·001).
conclusionSecondary transfer was associated with significantly delayed imaging, delayed surgery, and increased mortality. Key interventions were performed more quickly in MTCs than in TUs.
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