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Background: Under-triage of major trauma patients has been unavoidable, especially in the trauma system of rural area. Timely stabilization and transfer of critical trauma patients remains a great challenge for hospitals limited in resources for major trauma management. No definitive measure has been proved to improve the outcome of transferred major trauma patients. Current study hypothesized that regular feedback on inter-hospital transfer of patients with major trauma can improve care quality and outcome.Method: This retrospective cohort study retrieved the transferred trauma patients with injury severity score(ISS) ≥ 16 between Jan 2010 and Dec 2018 from the trauma registry databank of a tertiary medical center. Regular monthly feedback on inter-hospital transfer was initiated since 2014. The patients were divided into the without-feedback group and the with-feedback group. The demographic data, management before transfer, and outcome after transfer were collected and analyzed. Results: A total of 178 patients were included; 69 patients in the without-feedback and 109 in the with-feedback group. The with-feedback group had higher ISS (25 vs 27, p = 0.049), and more patients needing massive transfusion (14.49% vs 29.36%, p = 0.036). After adjusted for confounding factors, the with-feedback group was associated with higher rate of blood transfusion before transfer (adjusted odds ratio [aOR] 2.75, 95% CI [1.01-7.52], p = 0.049), shorter time span before blood transfusion (-31.80 ± 15.14, p = 0.038), and decreased mortality risk (aOR 0.33, 95% CI [0.13-0.83], p = 0.019).Conclusion: This retrospective cohort study revealed that regular feedback on inter-hospital transfer improved the quality of blood transfusion and was associated with decreased mortality risk. |
