最快者生存?对丹麦包容性创伤系统中主要送往或其次转往主要创伤中心的严重创伤患者的描述性分析

Thea Palsgaard Møller, Josefine Tangen Jensen, Roar Borregaard Medici, Søren Steemann Rudolph, Lars Bredevang Andersen, Jakob Roed, Stig Nikolaj Fasmer Blomberg, Helle Collatz Christensen, Mark Edwards
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引用次数: 0

摘要

创伤系统对提高创伤患者的生存率和生活质量至关重要。了解创伤分流和患者预后对于优化资源分配和创伤救治至关重要。该研究旨在探讨丹麦新西兰地区的院前创伤分流。具体来说,该研究描述了主要送往或次要转往主要创伤中心的患者的特征。2017 年 1 月至 2021 年 12 月期间,对严重受伤的创伤患者进行了一项回顾性描述研究。研究对象包括744名患者,其中55.6%为主要患者,44.4%为次要患者。总体而言,男性患者占 70.2%,66.1% 的患者年龄在 18-65 岁之间。与原发性患者相比,继发性患者中有更多女性--34.2%对26.3%,受伤严重程度评分≥15-59.6%对47.8%的比例更高。二级患者的 30 天存活率更高,为 92.7% 对 87%。医疗调度员将98.1%的一级患者和86.3%的二级患者的紧急程度评估为A级。由医生值班的院前医疗单位更频繁地首先救治初诊患者--17.1% 对 3.5%。响应时间相似,但初级患者在现场的时间更长,而二级患者从受伤到到达主要创伤中心的时间更长。二级创伤患者的受伤严重程度评分更高,存活率更高。医疗调度员认为他们的情况不那么紧急,由医生组成的小组也较少对他们进行评估。需要前瞻性的质量数据来进一步调查最佳分流和持续改进创伤护理质量。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Survival of the fastest? A descriptive analysis of severely injured trauma patients primarily admitted or secondarily transferred to major trauma centers in a Danish inclusive trauma system
Trauma systems are crucial for enhancing survival and quality of life for trauma patients. Understanding trauma triage and patient outcomes is essential for optimizing resource allocation and trauma care. The aim was to explore prehospital trauma triage in Region Zealand, Denmark. Specifically, characteristics for patients who were either primarily admitted or secondarily transferred to major trauma centers were described. A retrospective descriptive study of severely injured trauma patients was conducted from January 2017 to December 2021. The study comprised 744 patients including 55.6% primary and 44.4% secondary patients. Overall, men accounted for 70.2% of patients, and 66.1% were aged 18–65 years. The secondary patients included more women—34.2% versus 26.3% and a higher proportion of Injury Severity Score of ≥ 15—59.6% versus 47.8%, compared to primary patients. 30-day survival was higher for secondary patients—92.7% versus 87%. Medical dispatchers assessed urgency as Emergency level A for 98.1% of primary patients and 86.3% for secondary patients. Physician-staffed prehospital units attended primary patients first more frequently—17.1% versus 3.5%. Response times were similar, but time at scene was longer for primary patients whereas time from injury to arrival at a major trauma center was longer for secondary patients. Secondary trauma patients had higher Injury Severity Scores and better survival rates. They were considered less urgent by medical dispatchers and less frequently assessed by physician-staffed units. Prospective quality data are needed for further investigation of optimal triage and continuous quality improvement in trauma care.
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