Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Effects of Advanced Trauma Life Support® training compared with standard care on adult trauma patient outcomes (ADVANCE TRAUMA): study protocol for a stepped-wedge cluster randomised trial

Ranjan, Samriddhi ; Fälth, Sara ; Kharat, Prashant ; Bassi, Abhinav ; Bakhshi, Girish D. ; Basak, Debojit ; Berg, Johanna LU orcid ; Chatterjee, Shamita ; Felländer-Tsai, Li and Hemming, Karla , et al. (2026) In Trials 27(1). p.1-15
Abstract
Background
Advanced Trauma Life Support® (ATLS®) is the most widely adopted form of trauma life support training worldwide, but there is no high-quality evidence that it can improve patient outcomes. The aim of this trial is to compare the effects of ATLS® training with standard care on outcomes in adult trauma patients.

Methods
ADVANCE TRAUMA is a batched stepped-wedge cluster randomised controlled trial in India, where ATLS® is not routinely implemented. The trial will be conducted in 30 clusters (hospitals), organised into six batches of five clusters each. All clusters transition through three phases: first, a standard care phase; second, a 1-month transition phase, during which the training is delivered; and finally,... (More)
Background
Advanced Trauma Life Support® (ATLS®) is the most widely adopted form of trauma life support training worldwide, but there is no high-quality evidence that it can improve patient outcomes. The aim of this trial is to compare the effects of ATLS® training with standard care on outcomes in adult trauma patients.

Methods
ADVANCE TRAUMA is a batched stepped-wedge cluster randomised controlled trial in India, where ATLS® is not routinely implemented. The trial will be conducted in 30 clusters (hospitals), organised into six batches of five clusters each. All clusters transition through three phases: first, a standard care phase; second, a 1-month transition phase, during which the training is delivered; and finally, an intervention phase, for a total of 13 months. Each cluster is randomised to an implementation sequence that defines the duration of the standard care and intervention phases. The trial will include at least 4320 adult trauma patients (≥ 15 years) who present to emergency departments and are subsequently admitted or transferred for admission. The primary outcome is in-hospital mortality within 30 days of arrival at the emergency department.

Discussion
This will be the first large-scale trial to provide robust evidence of the effectiveness of ATLS® since the programme was initiated in 1978. Regardless of the findings, this study will have important implications for trauma life support training globally. If ATLS® training improves patient outcomes, ways to promote its use and optimise its implementation, especially in low- and middle-income countries such as India, should be explored. If patient outcomes do not improve, trauma life support training must change. (Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; and (Less)
publishing date
type
Contribution to journal
publication status
published
in
Trials
volume
27
issue
1
article number
176
pages
1 - 15
publisher
BioMed Central (BMC)
external identifiers
  • pmid:41630085
  • scopus:105030944031
ISSN
1745-6215
DOI
10.1186/s13063-026-09491-z
language
English
LU publication?
no
id
0d9a2c57-06e7-4278-80e3-a9e06a2d4819
date added to LUP
2026-03-04 20:16:30
date last changed
2026-03-05 07:38:19
@article{0d9a2c57-06e7-4278-80e3-a9e06a2d4819,
  abstract     = {{Background<br/>Advanced Trauma Life Support® (ATLS®) is the most widely adopted form of trauma life support training worldwide, but there is no high-quality evidence that it can improve patient outcomes. The aim of this trial is to compare the effects of ATLS® training with standard care on outcomes in adult trauma patients.<br/><br/>Methods<br/>ADVANCE TRAUMA is a batched stepped-wedge cluster randomised controlled trial in India, where ATLS® is not routinely implemented. The trial will be conducted in 30 clusters (hospitals), organised into six batches of five clusters each. All clusters transition through three phases: first, a standard care phase; second, a 1-month transition phase, during which the training is delivered; and finally, an intervention phase, for a total of 13 months. Each cluster is randomised to an implementation sequence that defines the duration of the standard care and intervention phases. The trial will include at least 4320 adult trauma patients (≥ 15 years) who present to emergency departments and are subsequently admitted or transferred for admission. The primary outcome is in-hospital mortality within 30 days of arrival at the emergency department.<br/><br/>Discussion<br/>This will be the first large-scale trial to provide robust evidence of the effectiveness of ATLS® since the programme was initiated in 1978. Regardless of the findings, this study will have important implications for trauma life support training globally. If ATLS® training improves patient outcomes, ways to promote its use and optimise its implementation, especially in low- and middle-income countries such as India, should be explored. If patient outcomes do not improve, trauma life support training must change.}},
  author       = {{Ranjan, Samriddhi and Fälth, Sara and Kharat, Prashant and Bassi, Abhinav and Bakhshi, Girish D. and Basak, Debojit and Berg, Johanna and Chatterjee, Shamita and Felländer-Tsai, Li and Hemming, Karla and Jha, Vivekanand and Kasza, Jessica and Khajanchi, Monty and Martin, James and Mishra, Anurag and Olofsson, Anna and Roy, Nobhojit and Singh, Rajdeep and Soni, Kapil Dev and Gerdin Wärnberg, Martin}},
  issn         = {{1745-6215}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{1--15}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Trials}},
  title        = {{Effects of Advanced Trauma Life Support® training compared with standard care on adult trauma patient outcomes (ADVANCE TRAUMA): study protocol for a stepped-wedge cluster randomised trial}},
  url          = {{http://dx.doi.org/10.1186/s13063-026-09491-z}},
  doi          = {{10.1186/s13063-026-09491-z}},
  volume       = {{27}},
  year         = {{2026}},
}