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Admission Route and In-Hospital Mortality Among Trauma Patients Admitted to a Regional Trauma Center in South Korea: A Retrospective Cohort Study

Year: 2026

Type: article

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.

Source: Journal of Clinical Medicine

DOI: 10.3390/jcm15207822

Authors: Hagi Jung, Iljae Wang, Wonwoong Tae, Seokran Yeom, Gibyung Lee, Sungwook Park

Institution: Pusan National University Hospital

Language: English

Topic: Trauma and Emergency Care Studies

Subfield: Emergency Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $3,137