Journal Club: Is the Golden Hour Tarnished? Registries and Multivariable Regression
Editor's Capsule Summary for Newgard et al1
What is already known on this topic
The “golden hour” concept in trauma is pervasive despite little evidence to support it.
What question this study addressed
Is there an association between various emergency medical services (EMS) intervals and inhospital mortality in seriously injured adults?
What this study adds to our knowledge
In 3,656 injured patients with substantial perturbations of vital signs or mental status, transported by 146 EMS agencies to 51 trauma centers across North America, no association was found among any EMS interval and mortality.
How this might change clinical practice
This study suggests that in our current out-of hospital and emergency care system time may be less crucial than once thought. Routine lights-and-sirens transport for trauma patients, with its inherent risks, may not be warranted.
Section editors: Tyler W. Barrett, MD; David L. Schriger, MD, MPH
SEE RELATED ARTICLE, P. 235.
Editor's Note: You are reading the 14th installment of Annals of Emergency Medicine Journal Club. This bimonthly feature seeks to improve the critical appraisal skills of emergency physicians and other interested readers through a guided critique of actual Annals of Emergency Medicine articles. Each Journal Club will pose questions that encourage readers—be they clinicians, academics, residents, or medical students—to critically appraise the literature. During a 2- to 3-year cycle, we plan to ask questions that cover the main topics in research methodology and critical appraisal of the literature. To do this, we will select articles that use a variety of study designs and analytic techniques. These may or may not be the most clinically important articles in a specific issue, but they are articles that serve the mission of covering the clinical epidemiology curriculum. Journal Club entries are published in 2 phases. In the first phase, a list of questions about the article is published in the issue in which the article appears. Questions are rated “novice,” (
) “intermediate,” (
) and “advanced” (
), so that individuals planning a journal club can assign the right question to the right student. The answers to this journal club will be published in the August 2010 issue. US residency directors will have immediate access to the answers through the Council of Emergency Medicine Residency Directors Share Point Web site. International residency directors can gain access to the questions by going to http://www.emergencymedicine.ucla.edu/annalsjc/ and following the directions. Thus, if a program conducts its journal club within 5 months of the publication of the questions, no one will have access to the published answers except the residency director. The purpose of delaying the publication of the answers is to promote discussion and critical review of the literature by residents and medical students and discourage regurgitation of the published answers. It is our hope that the Journal Club will broaden Annals of Emergency Medicine's appeal to residents and medical students. We are interested in receiving feedback about this feature. Please e-mail journalclub@acep.org with your comments.
PII: S0196-0644(10)00003-X
doi:10.1016/j.annemergmed.2010.01.001
© 2010 Published by Elsevier Inc.
Refers to article:
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Emergency Medical Services Intervals and Survival in Trauma: Assessment of the “Golden Hour” in a North American Prospective Cohort
, 24 September 2009
