Background The duration from emergency department (ED) to operative room (OR) is an important factor to predict the outcome in severe trauma patients. Trauma Fast Track (TFT) policy was established in Khon Kaen Hospital for 5 years. According to this policy, shorter duration from ED to OR (ED time) might be more safe life of the patients.

Methods Cross-sectional analytic study, the patients with penetrating torso and haemodynamic instability who admitted to Khon Kaen Hospital from October 2011 to September 2014 were included. The Fisher exact test were used for data analysis.

Results A total of 82 patients were included. Of these, penetrating injury to abdomen and chest were 78% and 22%, respectively. The mortality rate was 25.6%. The mean ED time were 43 minutes and Injury Severity Score (ISS) were 18.8. The ED time more than 30 minute [odds ratio (OR), 4.1; 95% confidence interval (CI): 1.2–13.6; P = 0.021], and ISS more than 15 [OR, 9.5; 95%, CI: 1.1–78.7; P = 0.021] were associated with increase mortality rate.

Conclusions The mortality rate of penetrating injury at torso with haemodynamic instability is significantly associated with duration from ED to OR and ISS. According to this result, unnecessary procedure or intervention at ER should be avoided.