Trauma patient outcome after the Prehospital Trauma Life Support program.
BACKGROUND
We have previously demonstrated a significant improvement in trauma patient outcome after the Advanced Trauma Life Support (ATLS) program in Trinidad and Tobago. In January of 1992, a Prehospital Trauma Life Support (PHTLS) program was also instituted. This study assessed trauma patient outcome after the PHTLS program.


METHODS
Morbidity (length of stay and degree of disability), mortality, injury severity score, mechanism of injury, age, and sex among all adult trauma patients transported by ambulance to the major trauma hospital were assessed between July of 1990 to December of 1991 (pre-PHTLS, n = 332) and January of 1994 to June of 1995 (post-PHTLS, n = 350).


RESULTS
Age, sex distribution, percentage blunt injury, and injury severity score were similar for both groups. Mortality pre-PHTLS (15.7%) was greater than post-PHTLS (10.6%). Length of stay and disability were statistically significantly decreased post-PHTLS. Age, injury severity score, and mechanism of injury were positively correlated with mortality in both periods. The previously reported post-ATLS mortality was similar to the pre-PHTLS mortality.


CONCLUSIONS
Post-PHTLS mortality and morbidity were significantly decreased, suggesting a positive impact of the PHTLS program on trauma patient outcome.
Ali
J
J
Department of Surgery, St. Michael's Hospital, University of Toronto, Ontario, Canada.
Adam
R U
RU
Gana
T J
TJ
Williams
J I
JI
D000328:Adult; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008020:Life Support Care; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016896:Treatment Outcome; D014300:Trinidad and Tobago / Q000453:epidemiology; D014947:Wounds and Injuries / Q000628:therapy*; D014949:Wounds, Nonpenetrating / Q000401:mortality; D014950:Wounds, Penetrating / Q000401:mortality