The overall effect on mortality and morbidity from prehospital transfer strategies has been a strongly debated topic for more than two decades. A 2015 systematic review1 on this issue only identified observational studies and most were retrospective. The latest period covered by this set of studies was up to 2010. 19 studies targeted major trauma from which five studies (three retrospective, one prospective, and one mixed) including 19 910 patients with adjusted outcomes compared initial triage with specialised centres and non-specialised centres.
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