Transportation Modes and Prehospital Care: A Secondary Analysis of Vertebral Injury Patients

Samaneh  Abiri; Esmaeal Rayat  Dost; Navid  Kalani; Lohrasb  Taheri; Amir Hossein  Pourdavood; Arman  Hakemi; Behrang Rezvani  Kakhki; Morteza Talebi  Doluee; Mahdi  Foroughian; Shahram  Shafa

doi:10.18502/jimc.v9i1.20480

Samaneh Abiri Department of Emergency Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
Esmaeal Rayat Dost Department of Emergency Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
Navid Kalani Research Center for Social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran
Lohrasb Taheri Department of Surgery, Jahrom University of Medical Sciences, Jahrom, Iran
Amir Hossein Pourdavood Department of Surgery, Research Center for Noncommunicable Diseases, Jahrom University of Medical Sciences, Jahrom, Iran
Arman Hakemi Department of Emergency Medicine, Faculty of Medicine, Torbat Jam University of Medical sciences, Torbat Jam, Iran
Behrang Rezvani Kakhki Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran
Morteza Talebi Doluee Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran
Mahdi Foroughian Department of Emergency Medicine, Faculty of Medicine, Mashhad University of Medical sciences, Mashhad, Iran
Shahram Shafa Department of Orthopedic Surgery, Jahrom University of Medical Sciences, Jahrom, Iran

DOI: https://doi.org/10.18502/jimc.v9i1.20480

Keywords: Accidental falls, Emergency medical services, Hospitals, Humans, Incidence, Spinal cord injuries, Walking

Abstract

Background: Adequate prehospital care for Spinal Cord Injuries (SCI) is vital, influencing patient outcomes. Proper transportation plays an important role in minimizing delays and optimizing care. Thus, this study was aimed at evaluating the impact of transportation mode of vertebral injury patients on SCI.

Methods: In this secondary study of Jahrom city’s vertebral injury cases (March 2021 to 2023), demographics, accident details, prehospital timelines, and classifying cases by transportation mode were highlighted. The key outcomes were spinal cord injury and the need for surgical intervention. Emphasizing spinal cord injury as the primary outcome, the aim was to find its correlation if exist with transportation type, adjustments were made on the severity and mechanism of accidents.

Results: There were 44 cases (58.6%) brought to hospital by Emergency Medical Services (EMS) and 31 cases (41.4%) who self-walked-in. There was a significant negative correlation between the time from admission to surgery and the time it takes for EMS to arrive at the scene (r=-0.409, p=0.006). There was a significant negative correlation between the GCS score during ambulation to the hospital and the time it takes for EMS to arrive at the scene (r=-0.290, p=0.041). Getting transferred between two hospitals was associated with delays in hospital arrival (p=0.036). EMS-referred patients had a higher incidence of spinal cord injury (25%) compared to self-referred patients (9.68%), though this difference was not statistically significant (p=0.134). Incidence of SCI in self-walked-in patients was statistically higher than EMS brought patients (p=0.013) only in falling down patients.

Conclusion: The data remains non conclusive about the issue that which method of arrival to hospital of being self-referred or being brought by EMS are superior.