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Transfer Time Above Two Hours Not Tied to Adverse Effects

Trauma patient outcomes do not appear to suffer as a result

THURSDAY, Dec. 23 (HealthDay News) -- Provider-determined transfer time that exceeds a mandated maximum of two hours may not result in poorer outcomes in trauma systems, according to research published in the December issue of the Archives of Surgery.

Marie L. Crandall, M.D., M.P.H., of Northwestern University in Chicago, and colleagues reviewed data on transfer time, degree of injury, mortality, and time to operating room at second facility for 22,447 interfacility transfers between 1999 and 2003 to evaluate compliance and outcomes in a system with a two-hour transfer rule.

The researchers found an overall transfer rate of 10.4 percent, with a median transfer time of two hours, 21 minutes. Twenty percent took place within two hours. Patients transferred within two hours were more severely injured and more likely to have surgery performed the day of transfer or to die than patients whose transfer took more than two hours.

"While the majority of transfers occur at greater than the mandated two-hour interval, the most seriously injured patients are reaching definitive care within two hours. Markers of acuity for patients transferred at greater than two hours parallel those of the general trauma patient population. These data suggest that, in this system, provider-determined transfer time that exceeds two hours has no adverse effect on patient outcome. It appears to accomplish recognition and rapid transport of the most seriously ill. This may obviate the need for onerous system mandates that are not feasible or have poor compliance," the authors write.

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