EpiC Study (2021-2024)
- The EpiC study is a prospective, multi-centre, observational cohort study of patients with prehospital and in-hospital major trauma. We prospectively and observationally collect prehospital and hospital data to assess the effects of prolonged time-to-trauma facility, and, separately, the effects of key prehospital interventions, on patients’ clinical outcomes. In this study, ‘prolonged time-to-trauma facility’ is defined as the duration of time that occurs from the time/point-of-injury until the patient receives definitive care and/or reaches a definitive (trauma) care facility.
- Our primary hypothesis is that a sigmoidal relationship will exist between prehospital time and 7-day mortality. The inflection point will represent a critical window of time for the patient to reach a trauma facility, after which 7-day mortality rates will accelerate from ‘low’ to ‘high’. This inflection point will be at 2 hours for non-compressible, and 4 hours for compressible, injuries.
- Our secondary hypothesis is that there will be non-linear associations between time (from injury to reaching the trauma centre) with post-injury morbidity endpoints.
- Mortality will be assessed prehospital and in-hospital (i.e. mortality up to 7 days). Morbidity will include (i) organ failure scores [e.g. coagulopathy, acute kidney injury], (ii) rates of surgical interventions [e.g. fasciotomies, tube thoracostomies], and (iii) Rates of post-injury infections [e.g. wound infections, sepsis].