Objective: To investigate the impact of trauma team activation (TTA) time on short term and long term mortality, as well as morbidity outcomes, in patients with polytrauma. Methods: A retrospective single center cohort study was conducted on 1,246 polytrauma patients (Injury Severity Score [ISS] ≥ 16) admitted to a Level 1 trauma center between January 2018 and December 2022. TTA time was defined as the interval from patient arrival at the emergency department (ED) to the time the full trauma team was assembled and ready for patient care. Patients were stratified into three groups based on TTA time: Group A (≤ 5 minutes, n=412), Group B (6–10 minutes, n=528), and Group C (> 10 minutes, n=306). The primary outcome measures were 24 hour, 30 day, and 1 year mortality rates. Secondary outcomes included the incidence of multiple organ dysfunction syndrome (MODS), length of intensive care unit (ICU) stay, total hospital length of stay, and rate of unplanned reoperations within 30 days. Results: The 24 hour mortality rate was significantly lower in Group A (3.2%) compared to Group B (7.0%) and Group C (14.4%) (P<0.001). Similarly, 30 day mortality was 8.0% in Group A, 15.2% in Group B, and 28.1% in Group C (P<0.001), while 1 year mortality showed the same trend (12.4% vs. 21.6% vs. 36.3%, P<0.001). Multivariate logistic regression analysis confirmed that TTA time > 10 minutes was an independent risk factor for 30 day mortality (OR=3.12, 95% CI=2.01–4.85, P<0.001) and MODS (OR=2.76, 95% CI=1.89–4.02, P<0.001). Group A also had shorter ICU stay (7.2 ± 2.8 days vs. 10.5 ± 3.5 days vs. 15.8 ± 4.2 days, P<0.001) and lower unplanned reoperation rate (5.6% vs. 9.8% vs. 17.3%, P<0.001) compared to Groups B and C. Conclusion: Prolonged trauma team activation time is independently associated with increased mortality and morbidity in polytrauma patients. Reducing TTA time to ≤ 5 minutes can significantly improve clinical outcomes, highlighting the need for optimized ED workflow and trauma team response protocols.
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