院前护理:从一级创伤中心311例死亡中吸取的教训。

IF 1.9 4区 医学 Q2 ORTHOPEDICS
Parvez Mohi Ud Din Dar, Supreet Kaur, Anand Kumar Katiyar, Pratyusha Priyadarshani, Subodh Kumar, Amit Gupta, Sushma Sagar
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引用次数: 0

摘要

目的:创伤是全球造成残疾和死亡的一个主要原因,因此强调了及时进行医疗干预的极端重要性,特别是在创伤后的“黄金一小时”内。然而,在中低收入国家,紧急医疗系统的缺失或新兴状态加剧了死亡率。本研究旨在回顾性分析印度一级创伤中心的死亡率,比较接受院前护理的患者和未接受院前护理的患者。方法:本回顾性观察研究于2019年4月至2020年4月在印度一家一级创伤中心进行,纳入住院期间死亡的创伤患者。排除包括(1)到达时死亡的患者,(2)接受心肺复苏的患者,以及(3)非创伤性死亡。对人口统计、临床概况、死亡原因和交通方式进行了仔细研究。数据包括病人转运细节、临床评估、干预措施、住院时间和死亡原因。采用SPSS 14进行统计学分析,差异有统计学意义,p < 0.05。结果:55,277例创伤患者中死亡311例。多数为男性(n=267, 83.9%),年龄21 ~ 40岁(n=133, 42.8%),以钝性创伤为主(97.4%)。以道路交通伤(180例,57.9%)和跌倒(95例,30.5%)为主。患者入院时常见气道威胁(n=144, 46.3%)、心动过速(n=159, 51.2%)、低血压(n=74, 23.8%)。颅脑外伤占70.4%。私家车运送了46.6%的患者,只有7.0%的患者在黄金时间内到达。虽然接受院前护理的患者延迟到达医院,但他们表现出更高的血氧饱和度和收缩压。结论:在资源匮乏的地区,加强院前护理和急救基础设施对降低创伤死亡率至关重要。虽然院前护理延迟了住院时间,但它对生理参数有积极影响,并可能改善患者的预后。这项研究强调了及时干预和综合EMS发展的必要性,以有效地解决全球创伤负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prehospital care: Lessons learned from 311 mortalities at level I trauma center.

Purpose: Trauma, a leading cause of disability and death globally, underscores the critical importance of timely medical intervention, particularly within the "golden hour" following trauma. Yet, in low-middle-income countries, the absence or fledgling state of emergency medical systems (EMS) exacerbates mortality rates. This study aims to retrospectively analyze mortalities at a level 1 trauma center in India, comparing patients who received prehospital care with those who did not.

Methods: Conducted at a level 1 trauma center in India from April 2019 to April 2020, this retrospective observational study included trauma patients who died during hospitalization. Exclusions comprised (1) patients deceased upon arrival, (2) patients receiving cardiopulmonary resuscitation, and (3) non-trauma deaths. Demographics, clinical profiles, causes of death, and transportation methods were scrutinized. Data encompassed patient transport details, clinical assessments, interventions, length of stay, and causes of death. Statistical analysis was performed using SPSS 14, with statistical significance set at p < 0.05.

Results: Among 55,277 trauma patients, 311 mortalities were recorded. Most were male (n=267, 83.9%), aged 21-40 years (n=133, 42.8%), with blunt trauma being the predominant cause (97.4%). The majority of patients had road traffic injuries (n=180, 57.9%) and falls (n=95, 30.5%). Threatened airway (n=144, 46.3%), tachycardia (n=159, 51.2%), and hypotension (n=74, 23.8%) were common on patients' arrival. Traumatic brain injuries (70.4%) prevailed. Private vehicles transported 46.6% of patients, while only 7.0% arrived within the golden hour. Although patients who received prehospital care experienced delayed hospital arrival, they exhibited higher oxygen saturation and systolic blood pressure.

Conclusion: Augmentation of prehospital care and EMS infrastructure in low-resource settings is crucial to mitigating trauma mortality. Although prehospital care delayed hospital arrival, it positively impacted physiological parameters and potentially improved patient outcomes. This study underscores the imperative of timely interventions and comprehensive EMS development to address the global trauma burden effectively.

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来源期刊
CiteScore
3.80
自引率
4.80%
发文量
1707
审稿时长
28 weeks
期刊介绍: Chinese Journal of Traumatology (CJT, ISSN 1008-1275) was launched in 1998 and is a peer-reviewed English journal authorized by Chinese Association of Trauma, Chinese Medical Association. It is multidisciplinary and designed to provide the most current and relevant information for both the clinical and basic research in the field of traumatic medicine. CJT primarily publishes expert forums, original papers, case reports and so on. Topics cover trauma system and management, surgical procedures, acute care, rehabilitation, post-traumatic complications, translational medicine, traffic medicine and other related areas. The journal especially emphasizes clinical application, technique, surgical video, guideline, recommendations for more effective surgical approaches.
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