Abstract
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.