Journal
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE
Volume 54, Issue 6, Pages 1188-1196Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/01.TA.0000073609.12530.19
Keywords
prehospital trauma system; trauma outcome; severity score; land mine; north Iraq; Cambodia
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Background. A five-year prospective study was conducted in North Iraq and Cambodia to test a model for rural prehospital trauma systems in low-income countries. Results: From 1997 to 2001, 135 local paramedics and 5,200 lay First Responders were trained to provide in-field trauma care. The study population comprised 1,061 trauma victims with mean evacuation time 5.7 hours. The trauma mortality rate was reduced from pre-intervention level at 40% to 14.9% over the study period (95% CI for difference 17.2-33.0%). There was a reduction in trauma deaths from 23.9% in 1997 to 8.8% in 2001 (95% CI for difference 7.8-22.4%), and a corresponding significant improvement of treatment effect by year. The rate of infectious complications remained at 21.5 percent throughout the study period. C onclusion. Low-cost rural trauma systems have a significant impact on trauma mortality in low-income countries.
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