Evidence map›Paper›PMID 36653031›Full record

ArticleCanadian journal of surgery. Journal canadien de chirurgie

Comparison of trauma care structures, processes and outcomes between the English National Health Service and Quebec, Canada.

Samy Bouderba, Fiona Lecky, Kahina Soltana, Xavier Neveu, Dhushy Surendra Kumar, Omar Bouamra, Timothy J Coats, Pier-Alexandre Tardif, Amina Belcaid, Catherine Gonthier and 1 more

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In one paragraph

Article in Canadian journal of surgery. Journal canadien de chirurgie. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Samy BouderbaFrom the Department of Social and Preventive Medicine, Université Laval, Québec, Que. (Bouderba, Soltana, Tardif, Moore); the Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de recherche du CHU de Quebec - Université Laval, Hôpital de l'Enfant-Jésus, Québec, Que. (Bouderba, Soltana, Neveu, Tardif, Moore); the Department of Emergency Medicine, University of Sheffield, Sheffield, UK (Lecky); the Trauma Audit and Research Network, Salford, UK (Kumar); the Department of Biology, Medicine and Health, Trauma Audit and Research Network, Manchester, UK (Bouamra); the Department of Cardiovascular Sciences, University of Leicester, Leicester, UK (Coats); and the Institut national d'excellence en santé et en services sociaux, Québec, Que. (Belcaid, Gonthier).
Fiona LeckyFrom the Department of Social and Preventive Medicine, Université Laval, Québec, Que. (Bouderba, Soltana, Tardif, Moore); the Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de recherche du CHU de Quebec - Université Laval, Hôpital de l'Enfant-Jésus, Québec, Que. (Bouderba, Soltana, Neveu, Tardif, Moore); the Department of Emergency Medicine, University of Sheffield, Sheffield, UK (Lecky); the Trauma Audit and Research Network, Salford, UK (Kumar); the Department of Biology, Medicine and Health, Trauma Audit and Research Network, Manchester, UK (Bouamra); the Department of Cardiovascular Sciences, University of Leicester, Leicester, UK (Coats); and the Institut national d'excellence en santé et en services sociaux, Québec, Que. (Belcaid, Gonthier).
Kahina SoltanaFrom the Department of Social and Preventive Medicine, Université Laval, Québec, Que. (Bouderba, Soltana, Tardif, Moore); the Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de recherche du CHU de Quebec - Université Laval, Hôpital de l'Enfant-Jésus, Québec, Que. (Bouderba, Soltana, Neveu, Tardif, Moore); the Department of Emergency Medicine, University of Sheffield, Sheffield, UK (Lecky); the Trauma Audit and Research Network, Salford, UK (Kumar); the Department of Biology, Medicine and Health, Trauma Audit and Research Network, Manchester, UK (Bouamra); the Department of Cardiovascular Sciences, University of Leicester, Leicester, UK (Coats); and the Institut national d'excellence en santé et en services sociaux, Québec, Que. (Belcaid, Gonthier).
Xavier NeveuFrom the Department of Social and Preventive Medicine, Université Laval, Québec, Que. (Bouderba, Soltana, Tardif, Moore); the Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de recherche du CHU de Quebec - Université Laval, Hôpital de l'Enfant-Jésus, Québec, Que. (Bouderba, Soltana, Neveu, Tardif, Moore); the Department of Emergency Medicine, University of Sheffield, Sheffield, UK (Lecky); the Trauma Audit and Research Network, Salford, UK (Kumar); the Department of Biology, Medicine and Health, Trauma Audit and Research Network, Manchester, UK (Bouamra); the Department of Cardiovascular Sciences, University of Leicester, Leicester, UK (Coats); and the Institut national d'excellence en santé et en services sociaux, Québec, Que. (Belcaid, Gonthier).
Dhushy Surendra KumarFrom the Department of Social and Preventive Medicine, Université Laval, Québec, Que. (Bouderba, Soltana, Tardif, Moore); the Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de recherche du CHU de Quebec - Université Laval, Hôpital de l'Enfant-Jésus, Québec, Que. (Bouderba, Soltana, Neveu, Tardif, Moore); the Department of Emergency Medicine, University of Sheffield, Sheffield, UK (Lecky); the Trauma Audit and Research Network, Salford, UK (Kumar); the Department of Biology, Medicine and Health, Trauma Audit and Research Network, Manchester, UK (Bouamra); the Department of Cardiovascular Sciences, University of Leicester, Leicester, UK (Coats); and the Institut national d'excellence en santé et en services sociaux, Québec, Que. (Belcaid, Gonthier).
Omar BouamraFrom the Department of Social and Preventive Medicine, Université Laval, Québec, Que. (Bouderba, Soltana, Tardif, Moore); the Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de recherche du CHU de Quebec - Université Laval, Hôpital de l'Enfant-Jésus, Québec, Que. (Bouderba, Soltana, Neveu, Tardif, Moore); the Department of Emergency Medicine, University of Sheffield, Sheffield, UK (Lecky); the Trauma Audit and Research Network, Salford, UK (Kumar); the Department of Biology, Medicine and Health, Trauma Audit and Research Network, Manchester, UK (Bouamra); the Department of Cardiovascular Sciences, University of Leicester, Leicester, UK (Coats); and the Institut national d'excellence en santé et en services sociaux, Québec, Que. (Belcaid, Gonthier).
Timothy J CoatsFrom the Department of Social and Preventive Medicine, Université Laval, Québec, Que. (Bouderba, Soltana, Tardif, Moore); the Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de recherche du CHU de Quebec - Université Laval, Hôpital de l'Enfant-Jésus, Québec, Que. (Bouderba, Soltana, Neveu, Tardif, Moore); the Department of Emergency Medicine, University of Sheffield, Sheffield, UK (Lecky); the Trauma Audit and Research Network, Salford, UK (Kumar); the Department of Biology, Medicine and Health, Trauma Audit and Research Network, Manchester, UK (Bouamra); the Department of Cardiovascular Sciences, University of Leicester, Leicester, UK (Coats); and the Institut national d'excellence en santé et en services sociaux, Québec, Que. (Belcaid, Gonthier).
Pier-Alexandre TardifFrom the Department of Social and Preventive Medicine, Université Laval, Québec, Que. (Bouderba, Soltana, Tardif, Moore); the Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de recherche du CHU de Quebec - Université Laval, Hôpital de l'Enfant-Jésus, Québec, Que. (Bouderba, Soltana, Neveu, Tardif, Moore); the Department of Emergency Medicine, University of Sheffield, Sheffield, UK (Lecky); the Trauma Audit and Research Network, Salford, UK (Kumar); the Department of Biology, Medicine and Health, Trauma Audit and Research Network, Manchester, UK (Bouamra); the Department of Cardiovascular Sciences, University of Leicester, Leicester, UK (Coats); and the Institut national d'excellence en santé et en services sociaux, Québec, Que. (Belcaid, Gonthier).
Amina BelcaidFrom the Department of Social and Preventive Medicine, Université Laval, Québec, Que. (Bouderba, Soltana, Tardif, Moore); the Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de recherche du CHU de Quebec - Université Laval, Hôpital de l'Enfant-Jésus, Québec, Que. (Bouderba, Soltana, Neveu, Tardif, Moore); the Department of Emergency Medicine, University of Sheffield, Sheffield, UK (Lecky); the Trauma Audit and Research Network, Salford, UK (Kumar); the Department of Biology, Medicine and Health, Trauma Audit and Research Network, Manchester, UK (Bouamra); the Department of Cardiovascular Sciences, University of Leicester, Leicester, UK (Coats); and the Institut national d'excellence en santé et en services sociaux, Québec, Que. (Belcaid, Gonthier).
Catherine GonthierFrom the Department of Social and Preventive Medicine, Université Laval, Québec, Que. (Bouderba, Soltana, Tardif, Moore); the Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de recherche du CHU de Quebec - Université Laval, Hôpital de l'Enfant-Jésus, Québec, Que. (Bouderba, Soltana, Neveu, Tardif, Moore); the Department of Emergency Medicine, University of Sheffield, Sheffield, UK (Lecky); the Trauma Audit and Research Network, Salford, UK (Kumar); the Department of Biology, Medicine and Health, Trauma Audit and Research Network, Manchester, UK (Bouamra); the Department of Cardiovascular Sciences, University of Leicester, Leicester, UK (Coats); and the Institut national d'excellence en santé et en services sociaux, Québec, Que. (Belcaid, Gonthier).
Lynne MooreFrom the Department of Social and Preventive Medicine, Université Laval, Québec, Que. (Bouderba, Soltana, Tardif, Moore); the Population Health and Optimal Health Practices Research Unit, Trauma-Emergency-Critical Care Medicine, Centre de recherche du CHU de Quebec - Université Laval, Hôpital de l'Enfant-Jésus, Québec, Que. (Bouderba, Soltana, Neveu, Tardif, Moore); the Department of Emergency Medicine, University of Sheffield, Sheffield, UK (Lecky); the Trauma Audit and Research Network, Salford, UK (Kumar); the Department of Biology, Medicine and Health, Trauma Audit and Research Network, Manchester, UK (Bouamra); the Department of Cardiovascular Sciences, University of Leicester, Leicester, UK (Coats); and the Institut national d'excellence en santé et en services sociaux, Québec, Que. (Belcaid, Gonthier) lynne.moore@fmed.ulaval.ca.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundComparisons across trauma systems are key to identifying opportunities to improve trauma care. We aimed to compare trauma service structures, processes and outcomes between the English National Health Service (NHS) and the province of Quebec, Canada.

methodsWe conducted a multicentre cohort study including admissions of patients aged older than 15 years with major trauma to major trauma centres (MTCs) from 2014/15 to 2016/17. We compared structures descriptively, and time to MTC and time in the emergency department (ED) using Wilcoxon tests. We compared mortality, and hospital and intensive care unit (ICU) length of stay (LOS) using multilevel logistic regression with propensity score adjustment, stratified by body region of the worst injury.

resultsThe sample comprised 36 337 patients from the NHS and 6484 patients from Quebec. Structural differences in the NHS included advanced prehospital medical teams (v. "scoop and run" in Quebec), helicopter transport (v. fixed-wing aircraft) and trauma team leaders. The median time to an MTC was shorter in Quebec than in the NHS for direct transports (1 h v. 1.5 h,

conclusionWe observed significant differences in the structure of trauma care, delays in access and risk-adjusted outcomes between Quebec and the NHS. Future research should assess associations between structures, processes and outcomes to identify opportunities for quality improvement.

Indexed as

State MedicineWounds and InjuriesAgedCohort StudiesEmergency Service, HospitalHospital MortalityHumansInjury Severity ScoreLength of StayQuebecRetrospective StudiesTrauma Centers

Identifiers

PMID36653031
PMCPMC9854907

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.