ArticleOsong public health and research perspectives2025
Impact of direct prehospital transport on mortality in patients with severe trauma based on the injury severity score: a nationwide observational study in the Republic of Korea.
Article in Osong public health and research perspectives, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Geospatial Optimization of Trauma Care Resource Allocation and Timely Access for Severely Injured Patients.JAMA network open · 2026Article
- Prehospital transport prioritization and time-varying selection bias in traffic-related multi-patient incidents: a nationwide retrospective cohort study.Critical care (London, England) · 2026Article
- Artificial intelligence and biohealth: the Republic of Korea's emerging priorities in health care R&D.Osong public health and research perspectives · 2025Article
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4 authors.
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Abstract
backgroundSevere trauma remains a leading cause of death in the Republic of Korea. In response, regional trauma centers were established in 2012. This study evaluated the impact of direct prehospital transport to trauma centers on in-hospital mortality among patients with severe trauma using the national trauma registry.
methodsThis nationwide observational study utilized data from the Korean community-based trauma registry between 2016 and 2020. Patients with an injury severity score >15 who were directly transported from the prehospital setting were included. Variables analyzed encompassed demographics, injury mechanism, transport time, hospital level, and outcomes. The primary outcome was in-hospital mortality. Both logistic regression and decision tree models were employed.
resultsA total of 24,567 patients were included. Overall mortality decreased by 5.2% during the study period. Patients transported to level 1 or 2 trauma centers had a lower mortality rate (23.6%) compared to those transported to level 3 or 4 hospitals (28.0%). The proportion of direct transports to high-level centers increased from 46.7% to 64.1% between 2016 and 2020. Despite longer transport times, patients transported to high-level institutions exhibited improved survival, particularly when transport exceeded 30 minutes, suggesting that hospital selection may be more critical than minimizing transport time.
conclusionDirect transport to high-level trauma centers improves survival among patients with severe trauma, even when transport times are prolonged. These findings support the importance of a well-organized trauma system that emphasizes hospital capability in prehospital triage decisions.
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