Interhospital transportation of major trauma patients in the Republic of Moldova

Abstract

Actuality Transportation of major trauma patients to, between, and within hospitals can be associated with potentially adverse events. Researchers have shown that increased vigilance, appropriate equipment, and well-trained personnel can lead to improved safety while major trauma patients are being transported. The aim of the study is to evaluate interhospital transportation of major trauma patients from district hospitals to trauma center on territory the Republic of Moldova. Materials and Methods Was performed retrospective analysis of 39 patients from archive, transferred from regional hospitals to National Centre of Emergency Medicine (NCEM) during the year 2008. Age between 20-74 years, 30 males, 9 females. Severity of trauma was evaluated according to NISS (New Injury Severity Score) with average value 45,1 ± 10,3 points, and MPMoIII (Mortality Probability Admission Model), with average value 67,3±18,9%. Patients were analyzed in dependencies on period of trauma, on distance and on severity of trauma. Results In table №1 is represented two comparable groups according to number of patients, gender, age, NISS. Patients who were transported before 48 hours were influenced by transportation more vastly (MPMoIII is higher) and had mortality in two times above. Rate of mortality was less for patients who were transported from distance < 70 km (table №2). Rate of mortality was directly dependant on severity of trauma (NISS) and conditions at admission (MPMoIII) in trauma center (table №3) and increased vastly in cause NISS>40 or MPMoIII>70%. Conclusions 1. It was observed some tendencies for major trauma patients during transportation. They depend on phase of trauma, distance between hospitals and severity of trauma according to NISS and MPMoIII. 2. The transportation of major trauma patients needs optimization through increasing caution, good equipping and special trained personal. 3. Activity of Department of Emergency Medicine should be directed on achievement of “Golden Hour” strategy in all territory the Republic of Moldova.