Is preoperative period associated with severity and unexpected death of injured patients needing emergency trauma surgery?

Introduction The 'golden hour' is a key concept in trauma care [1], as time plays a crucial role in saving the lives of severe trauma patients. Any delay in definitive [...]
Purpose Early operative control of hemorrhage is the key to saving the lives of severe trauma patients. We investigated whether emergency room (ER) stay time [time from the ER to the operating room (OR)] is associated with trauma severity and unexpected trauma death [Trauma and Injury Severity Score (TRISS) method-based probability of survival (Ps) [greater than or equal to]0.5 but died] of injured patients needing emergency trauma surgery. Methods We performed a retrospective review of all trauma patients requiring emergency surgery and all patients with pelvic fractures requiring transcatheter arterial embolization at our hospital from January 2002 to December 2012. We analyzed the relationships among injury severity on ER admission [Injury Severity Score (ISS); Revised Trauma Score (RTS); Ps; Shock Index (SI); American Society of Anesthesiologists Physical Status (ASA-PS)]; mortality rate; unexpected trauma death rate; and ER stay time. Results ER stay times were significantly shorter for patients with life-threatening conditions [RTS Conclusions Our results suggest that all medical staff should work together effectively on high-risk patients in the ER, bringing them immediately to the OR according to their level of risk. If injured patients need emergency trauma surgery, ER stay times should be kept as short as possible to reduce unexpected trauma death. Keywords Delaying factor * Emergency surgery * Preoperative period * Trauma * Unexpected trauma death