非区域性创伤中心创伤患者的可预防死亡率

K. Park, Wooram Choi, Sung-Bae Lee, K. Lee, Dongbeen Choi, Han-Gil Yoon, Ji Young Jang
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摘要

目的:一项关于可预防创伤死亡率(PTDR)的全国性研究(2012-2017 年)显示,区域创伤中心成立后,可预防创伤死亡率下降了 15.3%。然而,在设有急诊科的非创伤中心,有关创伤患者可预防死亡率的数据十分有限。因此,这项回顾性研究的目的是调查非区域创伤中心创伤患者的可预防死亡率,并确定启动创伤小组的效果:方法:2019 年 1 月至 2021 年 12 月期间,韩国国民健康保险一山医院(NHISIH)共记录了 46 例外伤患者死亡病例。考虑到 2020 年 4 月创伤小组的实施,专家小组对这些患者的可预防死亡进行了分析:所有死亡均可归因于钝性创伤,平均伤害严重程度评分为 26.0 ± 19.2,修订创伤评分为 5.05 ± 3.20,创伤和伤害评分为 56.6 ± 41.3。最常见的死亡原因是创伤性脑损伤,其次是呼吸骤停。最常见的错误是输血延迟,其次是出血治疗延迟。急诊室的治疗失误最多,其次是重症监护室。在创伤小组参与之前(2019 年 1 月至 2020 年 3 月)和 2020 年 4 月创伤小组启动之后,患者的 PTDR 分别从 27.27% 降至 4.27%(p = 0.021):结论:在一个非区域性创伤中心引入专门的创伤团队后,创伤患者的总体PTDR明显降低。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Preventable Death Rate of Trauma Patients in a Non-Regional Trauma Center
Purpose: A nationwide study (2012-2017) of preventable trauma death rates (PTDR) showed a 15.3% decrease after Regional Trauma centers were initiated. However, in non-trauma centers with an Emergency Department there is limited data of preventable mortality in trauma patients. Therefore, the purpose of this retrospective study was to investigate preventable mortality in trauma patients in a nonregional trauma center and determine the effect of initiating a Trauma Team.Methods: There were 46 deaths of trauma patients recorded in the National Health Insurance service Ilsan Hospital (NHISIH) in South Korea from January 2019 to December 2021. These patients’ preventable deaths were analyzed by an expert panel review considering the implementation of the Trauma Team in April 2020.Results: All deaths were attributable to blunt trauma with an average Injury Severity Score of 26.0 ± 19.2, Revised Trauma Score of 5.05 ± 3.20 and Trauma and Injury Score of 56.6 ± 41.3. The most frequent cause of death was traumatic brain injury followed by respiratory arrest. The most frequent error was delayed transfusion followed by delayed treatment of bleeding. Treatment errors occurred the most in the Emergency Room followed by the Intensive Care Unit. The PTDR of patients before the involvement of a Trauma Team (January 2019 to March 2020) and after the Trauma Team was initiated in April 2020 decreased from 27.27% to 4.27%, respectively (p = 0.021).Conclusion: The introduction of a dedicated Trauma Team in a non-regional trauma center significantly reduced the overall PTDR in trauma patients.
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