Prospective MAST study in 911 patients.
Nine hundred eleven patients with systolic blood pressures less than or equal to 90 mm Hg were randomized to MAST and No-MAST groups, and all taken to a single Level I Trauma Center. Epidemiologic analysis of etiology, age, race, sex, Trauma Scores, and Injury Severity Scores revealed the two groups to be statistically identical. Seven hundred eighty-four patients were analyzed in detail. The principal injury location was thorax in 41%, abdomen in 32%, extremity in 16%, head in 7%, and neck in 4%. In patients with head and extremity wounds, the mortality rate was clearly not a function of MAST use. In the chest, abdomen, and neck, MAST did not improve survival. Although the total prehospital time was 35.8 + 10.4 minutes for MAST patients and 32.5 +/- 10.7 minutes for No-MAST patients, 70% of patients with MAST had prehospital times greater than 30 minutes compared to 55% of the No-MAST patients. When the prehospital time was greater than 30 minutes, 31% of the MAST patients died, compared to 21% of the No-MAST patients. MAST application adversely affected the outcome most significantly for patients with cardiac and thoracic vascular injury. The overall mortality of 31% in the MAST group, compared to 25% in the No-MAST group was statistically significant (p = 0.05).
Mattox
K L
KL
Cora and Webb Mading Department of Surgery, Baylor College of Medicine, Houston, Texas 77030.
Bickell
W
W
Pepe
P E
PE
Burch
J
J
Feliciano
D
D
D000293:Adolescent; D000328:Adult; D005069:Evaluation Studies as Topic; D005392:First Aid; D005676:Gravity Suits; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D011446:Prospective Studies; D011897:Random Allocation; D012774:Shock, Traumatic / Q000401:mortality / Q000628:therapy*; D013781:Texas; D014505:Urban Population; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000401:mortality / Q000628:therapy; D014950:Wounds, Penetrating / Q000150:complications / Q000401:mortality / Q000628:therapy