Association between prehospital fluid resuscitation with crystalloids and outcome of trauma patients in Asia by a cross-national multicenter cohort study

The PATOS Clinical Research Network

doi:10.1038/s41598-022-06933-x

Association between prehospital fluid resuscitation with crystalloids and outcome of trauma patients in Asia by a cross-national multicenter cohort study

The PATOS Clinical Research Network

Department of Medicine

National Taiwan University
Far Eastern Memorial Hospital
Seoul Metropolitan Government-Seoul National University Boramae Medical Center
Universiti Teknologi MARA
Bach Mai Hospital
Hanoi Medical University
Vietnam National University, Hanoi
GVK EMRI
Indian Institute of Emergency Medical Services
Sri Ramachandra Institute of Higher Education and Research
Sungai Buloh Hospital
Sultanah Aminah Hospital
Seri Manjung Hospital
Pulau Pinang Hospital
Serdang Hospital
Kuala Lumpur Hospital
Sarikei Hospital
Sabah Women and Children’s Hospital
Ampang Hospital
Kajang Hospital
Miri Hospital
Sarawak General Hospital
Queen Elizabeth II Hospital
Teluk Intan Hospital
Raja Perempuan Zainab II Hospital
Kokushikan University
National Center for Global Health and Medicine
East Avenue Medical Center
Philippine College of Emergency Medicine
Southern Philippines Medical Centre
Pasig City General Hospital
Corazon Locsin Montelibano Memorial Regional Hospital
Seoul National University
Korea University
Samsung Medical Center, Sungkyunkwan university
Kyungpook National University
Yonsei University Wonju Severance Christian Hospital
Pusan National University
Chonnam National University
Chungbuk National University

Research output: Contribution to journal › Article › peer-review

14 Scopus citations

Abstract

Prehospital fluid resuscitation with crystalloids in patients following trauma remain controversial. This study aimed to investigate the association between prehospital fluid resuscitation and outcomes of trauma patients in Asia. We conducted a retrospective cohort study of trauma patients between 2016 and 2018 using data from the Pan-Asia Trauma Outcomes Study (PATOS) database. Prehospital fluid resuscitation was defined as any administration of intravenous crystalloid fluid on the ambulance before arrival to hospitals. The outcomes were in-hospital mortality and poor functional outcomes, defined as Modified Rankin Scale ≥ 4. Propensity score matching (PSM) was used to equalize potential prognostic factors in both groups. This study included 31,735 patients from six countries in Asia, and 4318 (13.6%) patients had ever received prehospital fluid resuscitation. The patients receiving prehospital fluid resuscitation had a higher risk of in-hospital mortality, with an adjusted odds ratio (aOR) of 2.02, 95% confidence interval (CI) 1.32–3.10, p = 0.001 in PSM analysis. Prehospital fluid resuscitation was also associated with poor functional outcomes, with an OR 1.73, 95% CI: 1.48–2.03, p < 0.001 in PSM analysis. Prehospital fluid resuscitation in patients with major trauma (injury severity score ≥ 16) presented a higher risk of poor functional outcomes (aOR = 2.65, 95% CI: 1.89–3.73 in PSM analysis, p_interaction = 0.006) via subgroup analysis. Prehospital fluid resuscitation of trauma patients is associated with higher in-hospital mortality and poor functional outcomes in the subgroup in countries studied.

Original language	English
Article number	4100
Journal	Scientific Reports
Volume	12
Issue number	1
DOIs	https://doi.org/10.1038/s41598-022-06933-x
State	Published - Dec 2022

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10.1038/s41598-022-06933-x

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@article{af32fcc5c5c947c29d0a561aed387a16,

title = "Association between prehospital fluid resuscitation with crystalloids and outcome of trauma patients in Asia by a cross-national multicenter cohort study",

abstract = "Prehospital fluid resuscitation with crystalloids in patients following trauma remain controversial. This study aimed to investigate the association between prehospital fluid resuscitation and outcomes of trauma patients in Asia. We conducted a retrospective cohort study of trauma patients between 2016 and 2018 using data from the Pan-Asia Trauma Outcomes Study (PATOS) database. Prehospital fluid resuscitation was defined as any administration of intravenous crystalloid fluid on the ambulance before arrival to hospitals. The outcomes were in-hospital mortality and poor functional outcomes, defined as Modified Rankin Scale ≥ 4. Propensity score matching (PSM) was used to equalize potential prognostic factors in both groups. This study included 31,735 patients from six countries in Asia, and 4318 (13.6\%) patients had ever received prehospital fluid resuscitation. The patients receiving prehospital fluid resuscitation had a higher risk of in-hospital mortality, with an adjusted odds ratio (aOR) of 2.02, 95\% confidence interval (CI) 1.32–3.10, p = 0.001 in PSM analysis. Prehospital fluid resuscitation was also associated with poor functional outcomes, with an OR 1.73, 95\% CI: 1.48–2.03, p < 0.001 in PSM analysis. Prehospital fluid resuscitation in patients with major trauma (injury severity score ≥ 16) presented a higher risk of poor functional outcomes (aOR = 2.65, 95\% CI: 1.89–3.73 in PSM analysis, pinteraction = 0.006) via subgroup analysis. Prehospital fluid resuscitation of trauma patients is associated with higher in-hospital mortality and poor functional outcomes in the subgroup in countries studied.",

author = "\{The PATOS Clinical Research Network\} and Sung, \{Chih Wei\} and Sun, \{Jen Tang\} and Huang, \{Edward Pei Chuan\} and Shin, \{Sang Do\} and Song, \{Kyoung Jun\} and Hong, \{Ki Jeong\} and Jamaluddin, \{Sabariah Faizah\} and Son, \{Do Ngoc\} and Hsieh, \{Ming Ju\} and Ma, \{Matthew Huei Ming\} and Hsu, \{Li Min\} and Chiang, \{Wen Chu\} and Ramana Rao and Abraham, \{George P.\} and Ramakrishnan, \{T. V.\} and Jamaluddin, \{Sabariah Faiwah\} and Mohidin, \{Mohd Amin Bin\} and Saim, \{Al Hilmi\} and Kean, \{Lim Chee\} and Cecilia Anthonysamy and Yssof, \{Shah Jahan Din Mohd\} and Ji, \{Kang Wen\} and Kheng, \{Cheah Phee\} and Ali, \{Shamila Bt Mohamad\} and Periyanayaki Ramanathan and Yang, \{Chia Boon\} and Chia, \{Hon Woei\} and Hamad, \{Hafidahwati Binti\} and Ismail, \{Samsu Ambia\} and Abdullah, \{Wan Rasydan B.Wan\} and Hideharu Tanaka and Akio Kimura and Bernadett Velasco and Gundran, \{Carlos D.\} and Pauline Convocar and Sabarre, \{Nerissa G.\} and Tiglao, \{Patrick Joseph\} and Song, \{Kyoung Jun\} and Joo Jeong and Moon, \{Sung Woo\} and Kim, \{Joo yeong\} and Cha, \{Won Chul\} and Lee, \{Seung Chul\} and Ahn, \{Jae Yun\} and Lee, \{Kang Hyeon\} and Yeom, \{Seok Ran\} and Ryu, \{Hyeon Ho\} and Kim, \{Su Jin\} and Kim, \{Sang Chul\} and Hu, \{Ray Heng\}",

note = "Publisher Copyright: {\textcopyright} 2022, The Author(s).",

year = "2022",

month = dec,

doi = "10.1038/s41598-022-06933-x",

language = "English",

volume = "12",

journal = "Scientific Reports",

issn = "2045-2322",

publisher = "Nature Research",

number = "1",

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TY - JOUR

T1 - Association between prehospital fluid resuscitation with crystalloids and outcome of trauma patients in Asia by a cross-national multicenter cohort study

AU - The PATOS Clinical Research Network

AU - Sung, Chih Wei

AU - Sun, Jen Tang

AU - Huang, Edward Pei Chuan

AU - Shin, Sang Do

AU - Song, Kyoung Jun

AU - Hong, Ki Jeong

AU - Jamaluddin, Sabariah Faizah

AU - Son, Do Ngoc

AU - Hsieh, Ming Ju

AU - Ma, Matthew Huei Ming

AU - Hsu, Li Min

AU - Chiang, Wen Chu

AU - Rao, Ramana

AU - Abraham, George P.

AU - Ramakrishnan, T. V.

AU - Jamaluddin, Sabariah Faiwah

AU - Mohidin, Mohd Amin Bin

AU - Saim, Al Hilmi

AU - Kean, Lim Chee

AU - Anthonysamy, Cecilia

AU - Yssof, Shah Jahan Din Mohd

AU - Ji, Kang Wen

AU - Kheng, Cheah Phee

AU - Ali, Shamila Bt Mohamad

AU - Ramanathan, Periyanayaki

AU - Yang, Chia Boon

AU - Chia, Hon Woei

AU - Hamad, Hafidahwati Binti

AU - Ismail, Samsu Ambia

AU - Abdullah, Wan Rasydan B.Wan

AU - Tanaka, Hideharu

AU - Kimura, Akio

AU - Velasco, Bernadett

AU - Gundran, Carlos D.

AU - Convocar, Pauline

AU - Sabarre, Nerissa G.

AU - Tiglao, Patrick Joseph

AU - Song, Kyoung Jun

AU - Jeong, Joo

AU - Moon, Sung Woo

AU - Kim, Joo yeong

AU - Cha, Won Chul

AU - Lee, Seung Chul

AU - Ahn, Jae Yun

AU - Lee, Kang Hyeon

AU - Yeom, Seok Ran

AU - Ryu, Hyeon Ho

AU - Kim, Su Jin

AU - Kim, Sang Chul

AU - Hu, Ray Heng

PY - 2022/12

Y1 - 2022/12

N2 - Prehospital fluid resuscitation with crystalloids in patients following trauma remain controversial. This study aimed to investigate the association between prehospital fluid resuscitation and outcomes of trauma patients in Asia. We conducted a retrospective cohort study of trauma patients between 2016 and 2018 using data from the Pan-Asia Trauma Outcomes Study (PATOS) database. Prehospital fluid resuscitation was defined as any administration of intravenous crystalloid fluid on the ambulance before arrival to hospitals. The outcomes were in-hospital mortality and poor functional outcomes, defined as Modified Rankin Scale ≥ 4. Propensity score matching (PSM) was used to equalize potential prognostic factors in both groups. This study included 31,735 patients from six countries in Asia, and 4318 (13.6%) patients had ever received prehospital fluid resuscitation. The patients receiving prehospital fluid resuscitation had a higher risk of in-hospital mortality, with an adjusted odds ratio (aOR) of 2.02, 95% confidence interval (CI) 1.32–3.10, p = 0.001 in PSM analysis. Prehospital fluid resuscitation was also associated with poor functional outcomes, with an OR 1.73, 95% CI: 1.48–2.03, p < 0.001 in PSM analysis. Prehospital fluid resuscitation in patients with major trauma (injury severity score ≥ 16) presented a higher risk of poor functional outcomes (aOR = 2.65, 95% CI: 1.89–3.73 in PSM analysis, pinteraction = 0.006) via subgroup analysis. Prehospital fluid resuscitation of trauma patients is associated with higher in-hospital mortality and poor functional outcomes in the subgroup in countries studied.

AB - Prehospital fluid resuscitation with crystalloids in patients following trauma remain controversial. This study aimed to investigate the association between prehospital fluid resuscitation and outcomes of trauma patients in Asia. We conducted a retrospective cohort study of trauma patients between 2016 and 2018 using data from the Pan-Asia Trauma Outcomes Study (PATOS) database. Prehospital fluid resuscitation was defined as any administration of intravenous crystalloid fluid on the ambulance before arrival to hospitals. The outcomes were in-hospital mortality and poor functional outcomes, defined as Modified Rankin Scale ≥ 4. Propensity score matching (PSM) was used to equalize potential prognostic factors in both groups. This study included 31,735 patients from six countries in Asia, and 4318 (13.6%) patients had ever received prehospital fluid resuscitation. The patients receiving prehospital fluid resuscitation had a higher risk of in-hospital mortality, with an adjusted odds ratio (aOR) of 2.02, 95% confidence interval (CI) 1.32–3.10, p = 0.001 in PSM analysis. Prehospital fluid resuscitation was also associated with poor functional outcomes, with an OR 1.73, 95% CI: 1.48–2.03, p < 0.001 in PSM analysis. Prehospital fluid resuscitation in patients with major trauma (injury severity score ≥ 16) presented a higher risk of poor functional outcomes (aOR = 2.65, 95% CI: 1.89–3.73 in PSM analysis, pinteraction = 0.006) via subgroup analysis. Prehospital fluid resuscitation of trauma patients is associated with higher in-hospital mortality and poor functional outcomes in the subgroup in countries studied.

UR - https://www.scopus.com/pages/publications/85126079644

U2 - 10.1038/s41598-022-06933-x

DO - 10.1038/s41598-022-06933-x

M3 - Article

C2 - 35260580

AN - SCOPUS:85126079644

SN - 2045-2322

VL - 12

JO - Scientific Reports

JF - Scientific Reports

IS - 1

M1 - 4100

ER -

Association between prehospital fluid resuscitation with crystalloids and outcome of trauma patients in Asia by a cross-national multicenter cohort study

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