Association of Scene Time with Mortality in Major Traumatic Injuries Arrived by Emergency Medical Service

IF 1.2 Q3 EMERGENCY MEDICINE
Yaowapha Siripakarn, Laongdao Triniti, Winchana Srivilaithon
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Abstract

Abstract Introduction: Trauma is a major cause of death worldwide, and prehospital care is critical to improve patient outcomes. However, there is controversy surrounding the effectiveness of limiting scene time to 10 min or less in the care of major trauma patients. This study aimed to investigate the association between scene time and mortality in major trauma patients. Methods: A retrospective cohort study was conducted on major trauma patients treated by the Thammasat University Hospital Emergency Medical Services (EMS) team from 2020 to 2022. We included traumatic adult patients who had an injury severity score (ISS) of 16 or higher. The primary outcome was 24-h mortality. Multivariable risk regression analysis was used to evaluate the independent effect of scene time on 24-h mortality. Results: A total of 104 patients were included, of whom 11.5% died within 24 h. After adjusting for age, systolic blood pressure, Glasgow Coma Scale, and ISS, patients who had a scene time over 10 min showed a significant association with mortality (33.3% vs. 8.7%, P = 0.031). Intravenous fluid administration at the scene showed a trend toward a significant association with mortality. Conclusions: This study provides evidence to support the importance of minimizing scene time for major trauma patients. The findings suggest that a balance between timely interventions and adequate resources should be considered to optimize patient outcomes. Further studies to investigate the impact of prehospital interventions on trauma patient outcomes are needed.
紧急医疗服务到达的重大创伤现场时间与死亡率的关系
摘要简介:创伤是世界范围内死亡的主要原因,院前护理对改善患者预后至关重要。然而,围绕将现场时间限制在10分钟或更短时间在重大创伤患者护理中的有效性存在争议。本研究旨在探讨重大创伤患者的现场时间与死亡率之间的关系。方法:对2020年至2022年在法政大学医院急诊医疗服务(EMS)团队治疗的重大创伤患者进行回顾性队列研究。我们纳入了损伤严重程度评分(ISS)为16或更高的创伤性成年患者。主要终点为24小时死亡率。采用多变量风险回归分析评价现场时间对24小时死亡率的独立影响。结果:共纳入104例患者,其中11.5%在24小时内死亡。在调整年龄、收缩压、格拉斯哥昏迷量表和ISS后,现场时间超过10分钟的患者与死亡率有显著相关性(33.3%比8.7%,P = 0.031)。现场静脉输液与死亡率有明显的联系。结论:本研究提供了证据,支持减少现场时间对重大创伤患者的重要性。研究结果表明,应考虑及时干预和充足资源之间的平衡,以优化患者的预后。需要进一步研究院前干预对创伤患者预后的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.90
自引率
7.10%
发文量
52
审稿时长
39 weeks
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