+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Prehospital intravenous fluid administration is associated with higher mortality in trauma patients: a National Trauma Data Bank analysis



Prehospital intravenous fluid administration is associated with higher mortality in trauma patients: a National Trauma Data Bank analysis



Annals of Surgery 253(2): 371-377



Prehospital intravenous (IV) fluid administration is common in trauma patients, although little evidence supports this practice. We hypothesized that trauma patients who received prehospital IV fluids have higher mortality than trauma patients who did not receive IV fluids in the prehospital setting. We performed a retrospective cohort study of patients from the National Trauma Data Bank. Multiple logistic regression was used with mortality as the primary outcome measure. We compared patients with versus without prehospital IV fluid administration, using patient demographics, mechanism, physiologic and anatomic injury severity, and other prehospital procedures as covariates. Subset analysis was performed based on mechanism (blunt/penetrating), hypotension, immediate surgery, severe head injury, and injury severity score. A total of 776,734 patients were studied. Approximately half (49.3%) received prehospital IV. Overall mortality was 4.6%. Unadjusted mortality was significantly higher in patients receiving prehospital IV fluids (4.8% vs. 4.5%, P < 0.001). Multivariable analysis demonstrated that patients receiving IV fluids were significantly more likely to die (odds ratio [OR] 1.11, 95% confidence interval [CI] 1.05–1.17). The association was identified in nearly all subsets of trauma patients. It is especially marked in patients with penetrating mechanism (OR 1.25, 95% CI 1.08–1.45), hypotension (OR 1.44, 95% CI1.29–1.59), severe head injury (OR 1.34, 95% CI 1.17–1.54), and patients undergoing immediate surgery (OR 1.35, 95% CI 1.22–1.50). The harm associated with prehospital IV fluid administration is significant for victims of trauma. The routine use of prehospital IV fluid administration for all trauma patients should be discouraged.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 060120806

Download citation: RISBibTeXText

PMID: 21178760

DOI: 10.1097/sla.0b013e318207c24f


Related references

Prehospital intravenous fluid administration is associated with higher mortality in trauma patients: a National Trauma Data Bank analysis. Annals of Surgery 259(2): E16, 2014

Prehospital intravenous fluid administration is associated with higher mortality in trauma patients. Annals of Surgery 259(2): E19-E19, 2014

Timing of mortality in pediatric trauma patients: A National Trauma Data Bank analysis. Journal of Pediatric Surgery 53(2): 344-351, 2017

Predictors of mortality among initially stable adult pelvic trauma patients in the US: Data analysis from the National Trauma Data Bank. Injury 46(11): 2113-2117, 2016

Shock index predicts mortality in geriatric trauma patients: an analysis of the National Trauma Data Bank. Journal of Trauma and Acute Care Surgery 76(4): 1111-1115, 2014

Impact of the 80-Hour Work Week on Mortality and Morbidity in Trauma Patients: An Analysis of the National Trauma Data Bank. Yearbook of Critical Care Medicine 2010: 297-299, 2010

Impact of the 80-hour work week on mortality and morbidity in trauma patients: an analysis of the National Trauma Data Bank. Journal of Surgical Research 154(1): 157-162, 2008

Ocular injuries in trauma patients: an analysis of 28,340 trauma admissions in the 2003-2007 National Trauma Data Bank National Sample Program. Journal of Trauma and Acute Care Surgery 73(5): 1308-1312, 2013

Impact of ACA-related Insurance Expansion Policies on Mortality and Access to Post-Discharge Care for Trauma Patients: An Analysis of the National Trauma Data Bank. Journal of Trauma and Acute Care Surgery 2018, 2018

Comparison of modified Kampala trauma score with trauma mortality prediction model and trauma-injury severity score: A National Trauma Data Bank Study. American Journal of Emergency Medicine 35(8): 1056-1059, 2017

Excess mortality, length of stay, and costs associated with serious hemorrhage among trauma patients: findings from the National Trauma Data Bank. American Surgeon 73(12): 1269-1274, 2008

Impact of Affordable Care Act-related insurance expansion policies on mortality and access to post-discharge care for trauma patients: an analysis of the National Trauma Data Bank. Journal of Trauma and Acute Care Surgery 86(2): 196-205, 2019

Mortality after emergency department thoracotomy for pediatric blunt trauma: Analysis of the National Trauma Data Bank 2007-2012. Journal of Pediatric Surgery 51(1): 163-167, 2016

Females have fewer complications and lower mortality following trauma than similarly injured males: A risk adjusted analysis of adults in the National Trauma Data Bank. Yearbook of Anesthesiology and Pain Management 2010: 198-200, 2010

Females have fewer complications and lower mortality following trauma than similarly injured males: a risk adjusted analysis of adults in the National Trauma Data Bank. Surgery 146(2): 308-315, 2009