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Factors Associated With Interhospital Transfer of Trauma Victims

Viel, Isabelle Lauria RN; Moura, Bruna Roberta Siqueira MSN, RN; Martuchi, Sérgio Dias MSN, RN; de Souza Nogueira, Lilia PhD, RN

doi: 10.1097/JTN.0000000000000452

This study aimed to identify the factors associated with interhospital transfer of trauma victims treated in the emergency department of a nontertiary hospital. Retrospective analysis of medical records of trauma victims treated from January to July 2014 in the emergency department of a hospital not specialized in trauma care and located in Brazil was undertaken. The inclusion criteria were as follows: being 15 years or older; being a trauma victim; having received prehospital care; and being admitted to the hospital directly from the scene of the accident. Pearson's chi-square, Mann–Whitney U, Fisher's exact tests, and multiple logistic regression were used in the analyses. The sample was made up of 246 patients, mostly men (67.9%) and blunt trauma victims (97.6%). The mean age of the trauma victims was 44.2 (SD = 22.1). Falls were the most frequent external cause (41.1%). Forty patients were transferred to a tertiary care center, mostly for orthopedic treatment (70%). The factors associated with interhospital transfer of victims were severity of the trauma according to the Injury Severity Score ([ISS]; mean ±SD of ISS = 8.1 ± 4.5; odds ratio = 1.14; 95% confidence interval [1.06, 1.24]; p = .001) and extremities/pelvic girdle as the body region most severely injured (mean ±SD of extremities/pelvic girdle Abbreviated Injury Scale score = 2.9 ± 0.5; odds ratio = 3.86; 95% confidence interval [1.71, 8.72; p = .001). Identification of the risk factors for interhospital transfer of trauma victims treated in hospitals without a trauma center provides important information for the creation of referral and counter-referral policies to facilitate the process and ensure definitive early treatment and improved patient survival.

Hospital Alemão Oswaldo Cruz, Sao Paulo, SP, Brazil (Ms Viel); and School of Nursing, University of São Paulo, Sao Paulo, SP, Brazil (Ms Moura, Mr Martuchi, and Dr Nogueira).

Correspondence: Lilia de Souza Nogueira, PhD, RN, Avenida Doutor Enéas de Carvalho Aguiar, 419, Cerqueira César, Sao Paulo, SP 05403-000, Brazil (

The authors declare no conflicts of interest.

Copyright © 2019 by the Society of Trauma Nurses.