Does the “Golden Hour” After Injury Really Matter?

Traditional dogma teaches that it is crucial for trauma patients to reach the hospital and be treated within 1 hour of injury (the “golden hour”). Investigators reviewed data from a large trauma registry to determine outcomes for two cohorts of patients: 778 with traumatic shock and 1239 with traumatic brain injury.

In the traumatic-shock cohort, 26% died within 28 days of injury (the primary endpoint). In the brain-injury cohort, 53% experienced a bad outcome, defined as a 6-month Glasgow Outcome Scale–Extended score of ≤4 (the primary endpoint). Out-of-hospital time longer than 1 hour versus shorter than 1 hour was not associated with worse outcomes. Among 484 traumatic-shock patients requiring early critical hospital resources, those arri…