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European Journal of Trauma and Emergency Surgery
Published in: European Journal of Trauma and Emergency Surgery 2/2022

Open Access 01-04-2022 | Shock | Original Article

Effect of fluid administration on scene to traffic accident patients by EMS personnel: a propensity score-matched study using population-based ambulance records and nationwide trauma registry in Japan

Authors: Yusuke Katayama, Tetsuhisa Kitamura, Kosuke Kiyohara, Kenichiro Ishida, Tomoya Hirose, Shunichiro Nakao, Jotaro Tachino, Tasuku Matsuyama, Takeyuki Kiguchi, Yutaka Umemura, Tomohiro Noda, Yuko Nakagawa, Takeshi Shimazu

Published in: European Journal of Trauma and Emergency Surgery | Issue 2/2022

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Abstract

Purpose

The aim of this study was to assess the effect of fluid administration by emergency life-saving technicians (ELST) on the prognosis of traffic accident patients by using a propensity score (PS)-matching method.

Methods

The study included traffic accident patients registered in the JTDB database from January 2016 to December 2017. The main outcome was hospital mortality, and the secondary outcome was cardiopulmonary arrest on hospital arrival (CPAOA). To reduce potential confounding effects in the comparisons between two groups, we estimated a propensity score (PS) by fitting a logistic regression model that was adjusted for 17 variables before the implementation of fluid administration by ELST at the scene.

Results

During the study period, 10,908 traffic accident patients were registered in the JTDB database, and we included 3502 patients in this study. Of these patients, 142 were administered fluid by ELST and 3360 were not administered fluid by ELST. After PS matching, 141 patients were selected from each group. In the PS-matched model, fluid administration by ELST at the scene was not associated with discharge to death (crude OR: 0.859 [95% CI, 0.500–1.475]; p = 0.582). However, the fluid group showed statistically better outcome for CPAOA than the no fluid group in the multiple logistic regression model (adjusted OR: 0.231 [95% CI, 0.055–0.967]; p = 0.045).

Conclusion

In this study, fluid administration to traffic accident patients by ELST was associated not with hospital mortality but with a lower proportion of CPAOA.
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Metadata
Title
Effect of fluid administration on scene to traffic accident patients by EMS personnel: a propensity score-matched study using population-based ambulance records and nationwide trauma registry in Japan
Authors
Yusuke Katayama
Tetsuhisa Kitamura
Kosuke Kiyohara
Kenichiro Ishida
Tomoya Hirose
Shunichiro Nakao
Jotaro Tachino
Tasuku Matsuyama
Takeyuki Kiguchi
Yutaka Umemura
Tomohiro Noda
Yuko Nakagawa
Takeshi Shimazu
Publication date
01-04-2022
Publisher
Springer Berlin Heidelberg
Keywords
Shock
Shock
Published in
European Journal of Trauma and Emergency Surgery / Issue 2/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-020-01590-z

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