Admission Route and In-Hospital Mortality Among Trauma Patients Admitted to a Regional Trauma Center in South Korea: A Retrospective Cohort Study
- 1Department of Emergency Medicine, Pusan National University Hospital, 179, Gudeok-ro, Seo-Gu, Busan 49241, Republic of Korea
Abstract
Background: Studies comparing interhospital transfer with direct admission have reported inconsistent associations with mortality, and Korean evidence is limited. We evaluated admission-route associations with in-hospital mortality among patients admitted to a South Korean regional trauma center and explored mortality-associated factors after transfer. Methods: This retrospective receiving-center cohort included trauma admissions during 2022–2024. Patients arriving in cardiac arrest who died without return of spontaneous circulation were excluded. Logistic regression estimated adjusted associations; additional analyses varied adjustment sets and cohort restrictions, and transferred-subgroup analyses were exploratory. Results: Among 2464 patients, 1504 arrived directly and 960 were transferred; mortality was 18.6% vs. 12.0%. Transfer was associated with lower adjusted mortality odds (adjusted odds ratio [aOR], 0.54; 95% confidence interval [CI], 0.39–0.75) within this selected receiving-center cohort. Omitting arrival physiology and injury-to-center time yielded an aOR of 0.42 (95% CI, 0.32–0.55). Age and arrival Glasgow Coma Scale (GCS) scores were associated with mortality among transferred patients (aOR, 2.03 [95% CI, 1.68–2.46] for age 70 vs. 60 years and 0.75 [0.71–0.79] per 1-point GCS increase). Conclusions: In this receiving-center cohort, transfer was associated with lower in-hospital mortality. Among transferred patients, older age and lower arrival GCS scores were exploratory prognostic markers. These associations should not be interpreted as causal, because transferred patients had to survive until arrival, prehospital severity was unmeasured, and arrival measures may reflect prior care.
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BibTeX
@article{jung2026admission,
title = {{Admission Route and In-Hospital Mortality Among Trauma Patients Admitted to a Regional Trauma Center in South Korea: A Retrospective Cohort Study}},
author = {Hagi Jung and Iljae Wang and Wonwoong Tae and Seokran Yeom and Gibyung Lee and Sungwook Park},
journal = {Journal of Clinical Medicine},
year = {2026},
month = oct,
doi = {10.3390/jcm15207822},
url = {https://www.mdpi.com/2077-0383/15/20/7822},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Admission Route and In-Hospital Mortality Among Trauma Patients Admitted to a Regional Trauma Center in South Korea: A Retrospective Cohort Study
AU - Hagi Jung
AU - Iljae Wang
AU - Wonwoong Tae
AU - Seokran Yeom
AU - Gibyung Lee
AU - Sungwook Park
PY - 2026
DA - 2026/10/10
JO - Journal of Clinical Medicine
DO - 10.3390/jcm15207822
UR - https://www.mdpi.com/2077-0383/15/20/7822
AB - Background: Studies comparing interhospital transfer with direct admission have reported inconsistent associations with mortality, and Korean evidence is limited. We evaluated admission-route associations with in-hospital mortality among patients admitted to a South Korean regional trauma center and explored mortality-associated factors after transfer. Methods: This retrospective receiving-center cohort included trauma admissions during 2022–2024. Patients arriving in cardiac arrest who died without return of spontaneous circulation were excluded. Logistic regression estimated adjusted associations; additional analyses varied adjustment sets and cohort restrictions, and transferred-subgroup analyses were exploratory. Results: Among 2464 patients, 1504 arrived directly and 960 were transferred; mortality was 18.6% vs. 12.0%. Transfer was associated with lower adjusted mortality odds (adjusted odds ratio [aOR], 0.54; 95% confidence interval [CI], 0.39–0.75) within this selected receiving-center cohort. Omitting arrival physiology and injury-to-center time yielded an aOR of 0.42 (95% CI, 0.32–0.55). Age and arrival Glasgow Coma Scale (GCS) scores were associated with mortality among transferred patients (aOR, 2.03 [95% CI, 1.68–2.46] for age 70 vs. 60 years and 0.75 [0.71–0.79] per 1-point GCS increase). Conclusions: In this receiving-center cohort, transfer was associated with lower in-hospital mortality. Among transferred patients, older age and lower arrival GCS scores were exploratory prognostic markers. These associations should not be interpreted as causal, because transferred patients had to survive until arrival, prehospital severity was unmeasured, and arrival measures may reflect prior care.
SN - 2077-0383
ER -