title: Prehospital Care and In-hospital Mortality of Trauma Patients in Iran.
abstract: BACKGROUND
  The aim of this study was to determine the effect of prehospital time and advanced trauma life support interventions for trauma patients transported to an Iranian Trauma Center.
  
  
  METHODS
  This study was a retrospective study of trauma victims presenting to a trauma center in central Iran by Emergency Medical Services (EMS) and hospitalized more than 24 hours. Demographic and injury characteristics were obtained, including accident location, damaged organs, injury mechanism, injury severity score, prehospital times (response, scene, and transport), interventions and in-hospital outcome.
  
  
  RESULTS
  Two thousand patients were studied with an average age of 36.3 (SD = 20.8) years; 83.1% were male. One hundred twenty patients (6.1%) died during hospitalization. The mean response time, at scene time and transport time were 6.6 (SD = 3), 11.1 (SD = 5.2) and 12.8 (SD = 9.4), respectively. There was a significant association of longer transport time to worse outcome (P = .02). There was a trend for patients with transport times >10 minutes to die (OR: 0.8; 95% CI, 0.1-6.59). Advanced Life Support (ALS) interventions were applied for patients with severe injuries (Revised Trauma Score ⩽7) and ALS intervention was associated with more time on scene. There was a positive association of survival with ALS interventions applied in suburban areas (P = .001).
  
  
  CONCLUSIONS
  In-hospital trauma mortality was more common for patients with severe injuries and long prehospital transport times. While more severely injured patients received ALS interventions and died, these interventions were associated with positive survival trends when conducted in suburban and out-of-city road locations with long transport times.
authors.affiliation: Trauma Research Center,Kashan University of Medical Sciences,Kashan,IRIran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Paravar
authors.affiliation: Trauma Research Center,Kashan University of Medical Sciences,Kashan,IRIran.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Hosseinpour
authors.affiliation: Trauma Research Center,Kashan University of Medical Sciences,Kashan,IRIran.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Mohammadzadeh
authors.affiliation: Trauma Research Center,Kashan University of Medical Sciences,Kashan,IRIran.
authors.forename: Azade Sadat
authors.initials: AS
authors.lastname: Mirzadeh
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003430:Cross-Sectional Studies; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015601:Injury Severity Score; D007492:Iran / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009104:Multiple Trauma / Q000401:mortality*; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D055815:Young Adult