[From accident to trauma center--the lapse of time for patients with severe head injuries].
BACKGROUND
Early neurosurgical intervention and specialised neurointensive care have been shown to decrease morbidity and mortality in cases of severe head injury. This makes quick or direct transfer to a trauma centre essential. The aim of this study was to investigate the time from the time of the accident required for secondarily transferred patients with head injury to arrive at the trauma centre in Aarhus.


METHODS
This was a descriptive study based on consecutive data on patients secondarily transferred to Aarhus Trauma Centre in 2003. Only patients with head injury admitted to the neurosurgical intensive care unit were included. The time of the accident was defined as the time of dispatch of the ambulance.


RESULTS
A total of 89 patients were transferred secondarily to the trauma centre in Aarhus 2003; 43 of these had head injury. The median Glasgow Coma Score was 6.5 (3-15). The median time from accident to arrival at the trauma centre was 3 hours and 50 minutes (44 minutes to 20 hours, 4 minutes), and 42% of the patients arrived later than 4 hours after the injury. The distance from the primary hospital to the trauma centre was between 1.9 and 172 kilometers, and there was no association between distance and time.


CONCLUSIONS
The time from accident to arrival at the trauma centre was long, considering the severity of the injuries and the short distances involved. Direct transfer from the site of accident to the trauma centre would almost certainly improve the time. This study gives a reference value for the Danish trauma system.
Sunesen
Kåre Gotschalck
KG
Vestre Ringgade 234 st. tv, DK-8000 Arhus C. jan@studmed.dk.
Pallesen
Jan
J
Kofoed-Nielsen
Jacob
J
Christensen
Erika Frischknecht
EF
D006259:Craniocerebral Trauma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D003718:Denmark; D015600:Glasgow Coma Scale; D006408:Hematoma, Subdural / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D015601:Injury Severity Score; D007362:Intensive Care Units; D019635:Neurosurgical Procedures; D010360:Patient Transfer; D011379:Prognosis; D012189:Retrospective Studies; D020206:Subarachnoid Hemorrhage, Traumatic / Q000175:diagnosis / Q000628:therapy; D013997:Time Factors; D014187:Transportation of Patients; D014193:Trauma Centers