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Table 1. Characteristics of the Study Population.

From: Factors Associated with Prolonged Prehospital On-Site Time in Adult Trauma Patients: A Nationwide Observational Study in Japan

Variables Total (n = 150,215)
Age: years, median (IQR) 64 (44-78)
Age groups: years, n (%)
　19-59 65,020 (43.2)
　60-69 24,165 (16.1)
　70-79 27,303 (18.2)
　80-89 26,038 (17.3)
　89 < 7,689 (5.1)
Sex, n (%)
　Male 92,263 (61.4)
　Female 57,921 (38.6)
　Missing 31 (<0.1)
Year, n (%)
　2004-2007 9,254 (6.2)
　2008-2010 16,791 (11.2)
　2011-2013 34,157 (22.7)
　2014-2016 49,239 (32.8)
　2017-2019 40,161 (26.7)
　Missing 613 (0.4)
Month, n (%)
　January-March 36,636 (24.4)
　April-June 35,359 (23.5)
　July-September 36,954 (24.6)
　October-December 40,618 (27.0)
　Missing 648 (0.4)
Days of the week, n (%)
　Weekdays 99,840 (66.5)
　Weekends/Holidays 50,353 (33.5)
　Missing 22 (<0.1)
Time, n (%)
　Daytime 61,315 (40.8)
　Nighttime 87,651 (58.4)
　Missing 1,249 (0.8)
Alcohol consumption, n (%)
　Yes 16,267 (10.8)
　No 84,244 (56.1)
　Missing 49,704 (33.1)
Type of trauma, n (%)
　Traffic accident 59,862 (39.8)
　Fall 72,659 (48.4)
　Other blunt trauma 10,086 (6.7)
　Penetrating trauma 5,039 (3.4)
　Missing 2,569 (1.7)
Cause of trauma, n (%)
　Accident 124,235 (82.7)
　Occupational injury 8,441 (5.6)
　Suicide 10,307 (6.9)
　Violence 2,076 (1.4)
　Unclassified/rare mechanisms 1,334 (0.9)
　Unknown/missing 3,822 (2.5)
Prehospital vital signs
Systolic blood pressure: mmHg, median (IQR) 139 (118-160)
Hypotension (< 90 mmHg) 7,378 (4.9)
　Missing, n (%) 16,400 (10.9)
Severity of trauma
Revised trauma score, median (IQR) 7.84 (7.26-7.84)
　Missing, n (%) 22,721 (15.1)
AIS
　AIS1 > 3, n (%) 47,109 (31.4)
　AIS2 > 3, n (%) 1,219 (0.8)
　AIS3 > 3, n (%) 847 (0.6)
　AIS4 > 3, n (%) 34,340 (22.9)
　AIS5 > 3, n (%) 7,046 (4.7)
　AIS6 > 3, n (%) 15,316 (10.2)
　AIS7 > 3, n (%) 7,551 (5.0)
　AIS8 > 3, n (%) 41,906 (27.9)
　AIS9 > 3, n (%) 78 (0.1)
Interventions before hospital arrival
Oxygen 69,902 (46.5)
Immobilization 82,518 (54.9)
Chest compression 5,982 (4.0)
Intravenous line placement 3,066 (2.0)
Defibrillation 312 (0.2)
Intubation 1,134 (0.8)
　Missing 9,858 (6.6)
Comorbidities
Mental disease 10,028 (6.7)
Chronic kidney disease on hemodialysis 2,191 (1.5)
Malignancy 4,079 (2.7)
Diabetes mellitus 16,541 (11.0)
Ischemic heart disease 5,789 (3.9)
Chronic heart disease 2,985 (2.0)
Cerebrovascular disease 7,786 (5.2)
Dementia/mental retardation 7,929 (5.3)
On-site time, median (IQR) 14 (10-20)
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Table 2. Univariable Logistic Regression Analysis of Variables Associated with the Length of On-Site Time.

From: Factors Associated with Prolonged Prehospital On-Site Time in Adult Trauma Patients: A Nationwide Observational Study in Japan

Variables Odds Ratio 95% confidence interval p-Value
Age groups: years
　19-59 Reference
　60-69 0.98 0.95 to 1.01 0.23
　70-79 0.92 0.90 to 1.91 <0.001
　80-89 0.88 0.85 to 0.90 <0.001
　89 < 0.80 0.76 to 0.83 < 0.001
Sex
　Male 1.18 1.16 to 1.21 < 0.001
Year
　2004-2007 Reference
　2008-2010 1.17 1.11 to 1.23 < 0.001
　2011-2013 1.26 1.21 to 1.32 < 0.001
　2014-2016 1.49 1.43 to 1.56 < 0.001
　2017-2019 1.53 1.46 to 1.60 < 0.001
Month
　January-March Reference
　April-June 0.89 0.86 to 0.91 < 0.001
　July-September 0.85 0.83 to 0.99 < 0.001
　October-December 0.91 0.88 to 0.93 < 0.001
Days of the week
　Weekdays Reference
　Weekends/Holidays 1.08 1.06 to 1.10 < 0.001
Time
　Daytime 0.75 0.74 to 0.77 < 0.001
Alcohol consumption
　Yes 1.44 1.39 to 1.49 < 0.001
Type of trauma
　Traffic accident Reference
　Fall 1.06 1.03 to 1.08 < 0.001
　Other blunt trauma 1.09 1.04 to 1.13 < 0.001
　Penetrating trauma 1.16 1.09 to 1.22 < 0.001
Cause of trauma
　Accident Reference
　Occupational injury 0.96 0.92 to 1.00 0.08
　Suicide 0.91 0.87 to 0.95 < 0.001
　Violence 1.45 1.33 to 1.58 < 0.001
　Unclassified/rare mechanisms 1.21 1.08 to 1.34 0.001
Prehospital vital signs
Hypotension (< 90 mmHg) 0.96 0.92 to 1.01 0.09
Severity of trauma
Revised trauma score 1.20 1.19 to 1.21 < 0.001
AIS
　AIS1 > 3 0.75 0.74 to 0.77 < 0.001
　AIS2 > 3 0.76 0.67 to 0.85 <0.001
　AIS3 > 3 0.74 0.64 to 0.85 <0.001
　AIS4 > 3 0.78 0.76 to 0.79 < 0.001
　AIS5 > 3 0.80 0.77 to 0.84 < 0.001
　AIS6 > 3 1.40 1.35 to 1.45 < 0.001
　AIS7 > 3 1.15 1.10 to 1.21 < 0.001
　AIS8 > 3 0.78 0.76 to 0.79 < 0.001
　AIS9 > 3 0.74 0.48 to 1.17 0.20
Interventions before hospital arrival
Oxygen 0.89 0.87 to 0.91 < 0.001
Immobilization 1.10 1.08 to 1.12 < 0.001
Chest compression 0.33 0.32 to 0.35 <0.001
Intravenous line placement 0.79 0.73 to 0.85 < 0.001
Defibrillation 0.47 0.37 to 0.60 <0.001
Intubation 0.59 0.52 to 0.66 < 0.001
Comorbidities
Mental disease 1.07 1.02 to 1.11 0.001
Chronic kidney disease on hemodialysis 1.10 1.01 to 1.19 0.04
Malignancy 1.12 1.05 to 1.19 0.001
Diabetes mellitus 1.08 1.05 to 1.12 <0.001
Ischemic heart disease 1.02 0.97 to 1.08 0.38
Chronic heart disease 0.93 0.87 to 1.00 0.06
Cerebrovascular disease 1.01 0.97 to 1.06 0.66
Dementia/mental retardation 0.90 0.86 to 0.94 <0.001
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Table 3. Multivariable Logistic Regression Analysis with Multiple Imputation for Missing Data.

From: Factors Associated with Prolonged Prehospital On-Site Time in Adult Trauma Patients: A Nationwide Observational Study in Japan

Variables Odds ratio 95% confidence interval p-Value
Age groups: years
　19-59 Reference
　60-69 1.00 0.97 To 1.03 0.96
　70-79 0.99 0.95 To 1.02 0.37
　80-89 0.98 0.94 To 1.01 0.22
　89 < 0.90 0.86 To 0.96 < 0.001
Sex
　Male 1.14 1.11 To 1.16 < 0.001
Year
　2004-2007 Reference
　2008-2010 1.15 1.09 to 1.22 < 0.001
　2011-2013 1.20 1.14 to 1.26 < 0.001
　2014-2016 1.38 1.32 to 1.45 < 0.001
　2017-2019 1.42 1.35 to 1.49 < 0.001
Month
　January-March Reference
　April-June 0.87 0.85 to 0.90 < 0.001
　July-September 0.84 0.82 to 0.87 < 0.001
　October-December 0.91 0.89 to 0.94 < 0.001
Days of the week
　Weekdays Reference
　Weekends/Holidays 1.06 1.03 to 1.08 < 0.001
Time
　Daytime 0.75 0.73 to 0.76 < 0.001
Alcohol consumption
　Yes 1.31 1.26 to 1.36 < 0.001
Type of trauma
　Traffic accident Reference
　Fall 1.07 1.05 to 1.10 < 0.001
　Other blunt trauma 1.12 1.07 to 1.18 < 0.001
　Penetrating trauma 1.07 0.99 to 1.15 0.09
Cause of trauma
　Accident Reference
　Occupational injury 0.95 0.91 to 1.00 0.07
　Suicide 1.20 1.13 to 1.27 < 0.001
　Violence 1.33 1.20 to 1.46 < 0.001
　Unclassified/rare mechanisms 1.12 1.01 to 1.25 0.04
Prehospital vital signs
Hypotension (< 90 mmHg) 1.15 1.09 to 1.22 < 0.001
Severity of trauma
Revised trauma score 1.21 1.20 to 1.23 < 0.001
AIS
　AIS1 > 3 0.81 0.79 to 0.84 < 0.001
　AIS2 > 3 0.87 0.77 to 0.98 0.02
　AIS3 > 3 0.92 0.79 to 1.07 0.28
　AIS4 > 3 0.91 0.89 to 0.94 < 0.001
　AIS5 > 3 0.86 0.82 to 0.91 < 0.001
　AIS6 > 3 1.21 1.17 to 1.25 < 0.001
　AIS7 > 3 1.15 1.10 to 1.21 < 0.001
　AIS8 > 3 0.81 0.79 to 0.83 < 0.001
　AIS9 > 3 0.83 0.52 to 1.32 0.44
Interventions before hospital arrival
Oxygen 0.92 0.90 to 0.95 < 0.001
Immobilization 1.25 1.22 to 1.28 < 0.001
Chest compression 1.07 0.98 to 1.17 0.16
Intravenous line placement 1.27 1.17 to 1.37 < 0.001
Defibrillation 1.03 0.80 to 1.32 0.81
Intubation 1.44 1.26 to 1.64 < 0.001
Comorbidities
Mental disease 1.07 1.02 to 1.13 0.003
Chronic kidney disease on hemodialysis 1.12 1.03 to 1.22 0.01
Malignancy 1.11 1.04 to 1.18 0.002
Diabetes mellitus 1.03 1.00 to 1.07 0.08
Ischemic heart disease 1.04 0.98 to 1.10 0.17
Chronic heart disease 0.98 0.91 to 1.06 0.61
Cerebrovascular disease 1.03 0.98 to 1.08 0.20
Dementia/mental retardation 0.99 0.94 to 1.03 0.56
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Table 4. Multivariable Logistic Regression Analysis with Complete Data.

From: Factors Associated with Prolonged Prehospital On-Site Time in Adult Trauma Patients: A Nationwide Observational Study in Japan

Variables Odds ratio 95% confidence interval p-Value
Age groups: years
　19-59 Reference
　60-69 0.98 0.94 to 1.02 0.34
　70-79 0.98 0.94 to 1.03 0.51
　80-89 0.96 0.92 to 1.01 0.17
　89 < 0.92 0.85 to 1.00 0.047
Sex
　Male 1.08 1.05 to 1.12 < 0.001
Year
　2004-2007 Reference
　2008-2010 1.25 1.17 to 1.36 < 0.001
　2011-2013 1.35 1.26 to 1.45 < 0.001
　2014-2016 1.41 1.32 to 1.51 < 0.001
　2017-2019 1.49 1.39 to 1.60 < 0.001
Month
　January-March Reference
　April-June 0.85 0.81 to 0.88 < 0.001
　July-September 0.82 0.79 to 0.86 < 0.001
　October-December 0.90 0.86 to 0.93 < 0.001
Days of the week
　Weekdays Reference
　Weekends/Holidays 1.07 1.03 to 1.10 < 0.001
Time
　Daytime 0.73 0.71 to 0.75 < 0.001
Alcohol consumption
　Yes 1.30 1.24 to 1.36 < 0.001
Type of trauma
　Traffic accident Reference
　Fall 1.06 1.02 to 1.10 0.001
　Other blunt trauma 0.97 0.91 to 1.04 0.44
　Penetrating trauma 0.92 0.82 to 1.02 0.12
Cause of trauma
　Accident Reference
　Occupational injury 0.99 0.93 to 1.06 0.87
　Suicide 1.24 1.14 to 1.36 < 0.001
　Violence 1.45 1.27 to 1.66 < 0.001
　Unclassified/rare mechanisms 1.43 1.21 to 1.68 < 0.001
Prehospital vital signs
Hypotension (< 90 mmHg) 1.13 1.05 to 1,21 < 0.001
Severity of trauma
Revised trauma score 1.27 1.24 to 1.29 < 0.001
AIS
　AIS1 > 3 0.86 0.83 to 0.89 < 0.001
　AIS2 > 3 0.86 0.72 to 1.03 0.10
　AIS3 > 3 0.83 0.62 to 1.10 0.19
　AIS4 > 3 0.93 0.90 to 0.97 0.001
　AIS5 > 3 0.88 0.82 to 0.95 0.001
　AIS6 > 3 1.29 1.22 to 1.36 < 0.001
　AIS7 > 3 1.23 1.15 to 1.32 < 0.001
　AIS8 > 3 0.88 0.85 to 0.92 < 0.001
　AIS9 > 3 0.66 0.32 to 1.34 0.25
Interventions before hospital arrival
Oxygen 0.89 0.86 to 0.92 < 0.001
Immobilization 1.20 1.15 to 1.24 < 0.001
Chest compression 1.67 1.24 to 2.24 0.001
Intravenous line placement 1.06 0.91 to 1.22 0.46
Defibrillation 0.56 0.23 to 1.32 0.18
Intubation 1.18 0.84 to 1.66 0.34
Comorbidities
Mental disease 1.07 1.00 to 1.14 0.06
Chronic kidney disease on hemodialysis 1.18 1.04 to 1.33 0.008
Malignancy 1.16 1.06 to 1.26 0.001
Diabetes mellitus 1.00 0.95 to 1.05 0.95
Ischemic heart disease 1.08 1.00 to 1.17 0.04
Chronic heart disease 0.97 0.88 to 1.08 0.62
Cerebrovascular disease 1.12 1.05 to 1.19 0.001
Dementia/mental retardation 1.01 0.94 to 1.08 0.82
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