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Citation
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Boyle K, Dodgion CM, Milia DJ, Kaufman EJ, Cannon JW, Holena DN. J. Am. Coll. Surg. 2022; 235(5): S305. |
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Abstract
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INTRODUCTION: Previous studies have found that private vehicle transport (PVT) is associated with decreased mortality compared to ground ambulance transport (GAT) after penetrating trauma, but these studies were not focused specifically on firearm injuries and used data now a decade old. We hypothesized that in current times, PVT would be associated with lower mortality than GAT in patients with firearm injuries.
METHODS: We performed a retrospective study of the 2019 NTDB including patients with firearm assaults, older than 17 years, and transported by GAT or PVT. Interhospital transfers were excluded. After imputing missing data, we used coarsened exact matching on variables including demographics, presenting vital signs, and injury severity. To evaluate whether our findings were robust to methodologic specification, we repeated our analysis using multivariable logistic regression mortality models.
RESULTS: We included 21,601 firearm assaults (87.7% male, median age 28 [interquartile range 22 to 37) years, median NISS 1 [interquartile range 4 to 25]), of which 18.4% were transported by PVT. Unadjusted overall mortality was 14.1% and was higher in GAT compared with PVT (16.3% vs 4.6%, p < 0.001; Figure). Coarsened exact matching yielded 18,422 matched pairs in 349 strata, after which there was no significant difference in mortality for PVT vs GAT (odds ratio 0.94, 95% CI 0.79 to 1.14). In multivariable logistic regression modeling, there was again no difference in mortality for PVT vs GAT (odds ratio 0.82, 95% CI 0.61 to 1.01).
Language: en |