Effectiveness of Trauma Fast Track Protocol in Surat Thani Hospital
Keywords:
Trauma patients, Trauma Fast Track, ER to OR timeAbstract
Background: The trauma audit showed that delayed operative surgery was the most important problem for the mortality rate in trauma patients. This study aims to compare timing from the emergency room (ER) to the operative room (OR) and the mortality rate of trauma patients with blunt or penetrated abdomen or active vascular injury with shock before and after trauma fast track (TFT) was established in Surat Thani Hospital.
Materials and Methods: Prospective comparative study with historical control aimed to analyze the association between factors in fast-track trauma patients who visit the Emergency Department (ED) of our hospital between 1 September 2019 to 31 March 2022. We collected 190 trauma patients who met the criteria of TFT. The outcomes were analyzed, including comparing timing from ER to OR, mortality rate, and factors associated with mortality. Given a statistically significant difference of p-value < 0.05.
Results: There were 87 patients in the pre-protocol group and 103 patients in the post-protocol group. The results showed average times from ER to OR time in the post-protocol group were less than the pre-protocol group (31 vs. 58-minute, p-value < 0.001). The mortality cases of the pre- and post-protocol groups were 20 cases (24.10%) and 13 cases (12.15%); respectively, the p-value was 0.031. However, we found that several factors correlated with mortality rate.
Conclusion: After implementing the TFT, injured patients underwent surgery earlier, and the mortality rate decreased. To improve survival, the assessment and referral system and quality of care should be improved and standardized.
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