Physician-staffed prehospital units for severely injured patients in the Stockholm trauma system – is there a survival benefit?

Background The role of prehospital physicians for patients with major trauma has previously been examined with mixed results. No studies have assessed the survival benefit of physician-staffed prehospital units in the context of the Stockholm trauma system. Aim To investigate the association between exposure to prehospital physicians and mortality for severely injured trauma patients in the Stockholm trauma system. Methods A total of 11,063 trauma patients were obtained from the Swedish Trauma Registry and stratified according to physician exposure in the prehospital setting. Logistic regression was used to evaluate the association between prehospital physician exposure and 30-day mortality and Glasgow Outcome Score (GOS). Results No significant reduction in 30-day mortality was observed in the P-EMS group compared to the EMS group (OR 1.06, p = 0.71). However, transport with helicopter emergency medical services (HEMS) was independently associated with greater odds of survival. The P-EMS group had significantly lower GOS at discharge compared to EMS (OR 1.72, p < 0.001). Conclusion The potential benefit of prehospital physician exposure for major trauma patients remains uncertain. However, HEMS transport was associated with improved survival. Further research is needed to determine which patients benefit from prehospital physicians and to evaluate the optimal allocation of prehospital resources.