ArticleScandinavian journal of trauma, resuscitation and emergency medicine2023
The forgotten cohort-lessons learned from prehospital trauma death: a retrospective cohort study.
Article in Scandinavian journal of trauma, resuscitation and emergency medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 13 citations in OpenAlex.
- Unlocking survival in traumatic cardiac arrest: global insights, innovations, and unmet needs.Critical care (London, England) · 2025Review
- Diagnostic performance of prehospital EFAST in predicting CT scan injuries in severe trauma patients: a multicenter cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Article
- Accuracy between prehospital and hospital diagnosis in helicopter emergency medical services and its consequences for trauma care.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Article
- Exploring factors influencing time from dispatch to unit availability according to the transport decision in the pre-hospital setting: an exploratory study.BMC emergency medicine · 2024Article
- Prehospital and emergency department airway management of severe penetrating trauma in Sweden during the past decade.Scandinavian journal of trauma, resuscitation and emergency medicine · 2023Observational
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTrauma related deaths remain a relevant public health problem, in particular in the younger male population. A significant number of these deaths occur prehospitally without transfer to a hospital. These patients, sometimes termed "the forgotten cohort", are usually not included in clinical registries, resulting in a lack of information about prehospitally trauma deaths. The aim of the present study was to compare patients who died prehospital with those who sustained life-threatening injuries in order to analyze and potentially improve prehospital strategies.
methodsThis cohort study included all primary operations carried out by Switzerland's largest helicopter emergency medical service (HEMS) between January 1, 2011, and December 31, 2021. We included all adult trauma patients with life-threatening or fatal conditions. The outcome of this study is the vital status of the patient at the end of mission, i.e. fatal or life-threatening. Injury, rescue characteristics, and interventions of the forgotten trauma cohort, defined as patients with a fatal injury (NACA score of VII), were compared with life-threatening injuries (NACA score V and VI).
resultsOf 110,331 HEMS missions, 5534 primary operations were finally analyzed, including 5191 (93.8%) life-threatening and 343 (6.2%) fatal injuries. More than two-thirds of patients (n = 3772, 68.2%) had a traumatic brain injury without a significant difference between the two groups (p > 0.05). Thoracic trauma (44.6% vs. 28.7%, p < 0.001) and abdominal trauma (22.2% vs. 16.1%, p = 0.004) were more frequent in fatal missions whereas pelvic trauma was similar between the two groups (13.4% vs. 12.9%, p = 0.788). Pneumothorax decompression rate (17.2% vs. 3.7%, p < 0.001) was higher in the forgotten cohort group and measures for bleeding control (15.2% vs. 42.7%, p < 0.001) and pelvic belt application (2.9% vs. 13.1% p < 0.001) were more common in the life-threating injury group.
conclusionChest decompression rates and measures for early hemorrhage control are areas for potential improvement in prehospital care.
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