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European Journal of Trauma and Emergency Surgery

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Open Access 11-05-2022 | Original Article

Process times of severely injured patients in the emergency room are associated with patient volume: a registry-based analysis

Authors: Rolf Lefering, Christian Waydhas, TraumaRegister DGU

Published in: European Journal of Trauma and Emergency Surgery | Issue 6/2022

Abstract

Purpose

Hospitals involved in the care of severely injured patients treat a varying number of such cases per year. Large hospitals were expected to show a better performance regarding process times in the emergency room. The present investigation analyzed whether this assumption was true, based on a large national trauma registry.

Methods

A total of 129,193 severely injured patients admitted primarily to one of 675 German hospitals and documented in the TraumaRegister DGU^® were considered for this analysis. The analysis covered a 5 years time period (2013–2017). Hospitals were grouped by their average number of annually treated severe trauma patients into five categories ranging from ‘less than 10 patients’ to ‘100 or more’. The following process times were compared: pre-hospital time; time from admission to diagnostic procedures (sonography, X-ray, computed tomography), time from admission to selected emergency interventions and time in the emergency room.

Results

Seventy-eight high volume hospitals treated 45% of all patients, while 30% of hospitals treated less than ten cases per year. Injury severity and mortality increased with volume per year. Whole-body computed tomography (WB-CT) was used less frequently in small hospitals (53%) as compared to the large ones (83%). The average time to WB-CT fell from 28 min. in small hospitals to 19 min. in high volume hospitals. There was a linear trend to shorter performance times for all diagnostic procedures (sonography, X-ray, WB-CT) when the annual volume increased. A similar trend was observed for time to blood transfusion (58 min versus 44 min). The median time in the emergency room fell from 74 min to 53 min, but there was no clear trend for the time to the first emergency surgery. Due to longer travel times, prehospital time was about 10 min higher in patients admitted to high volume hospitals compared to patients admitted to smaller local hospitals.

Conclusion

Process times in the emergency room decreased consistently with an increase of patient volume per year. This decrease, however, was associated with a longer prehospital time.

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Title: Process times of severely injured patients in the emergency room are associated with patient volume: a registry-based analysis
Authors: Rolf Lefering
Christian Waydhas
TraumaRegister DGU
Publication date: 11-05-2022
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 6/2022
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-022-01987-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Process times of severely injured patients in the emergency room are associated with patient volume: a registry-based analysis

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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