科研之友
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摘要
Introduction: Some major trauma patients in metropolitan Perth (area 5000 km(2)) are initially transported to a secondary hospital (non-trauma centre), rather than directly to a tertiary hospital (trauma centre). They are subsequently transferred to a tertiary hospital. We compared outcomes from these different systems of care.
Methods: Major trauma (Injury Severity Score, ISS > 15) data from the Trauma Registries, 1 July 1997-30 June 2006. Two groups were studied: group 1 (metropolitan major trauma transported directly to a tertiary hospital) and group 2 (metropolitan major trauma transported initially to a secondary hospital and then to a tertiary hospital). The primary endpoint was death.
Results: Group 1 (n = 2005) and group 2 (n = 1078) mean age (43.9 +/- 24.3 yrs vs. 39.1 +/- 24.3 yrs, p < 0.0001) both with a median ISS = 24 (p = 0.084). Group 2 had significantly more head/neck injuries (p < 0.0001) and significantly less thoracic, abdominal and pelvis/extremities injuries (p < 0.0001). There were also a significantly greater total number of regions injured in group 1 vs. group 2 (p < 0.0001). Mean times to definitive care were 59 min vs. 4.5 h, respectively (p < 0.0001). After adjusting for age, ISS, RTS, total regions injured and time, the OR for death in group 2 was 0.99 (95% CI 0.58-1.68).
Conclusion: There is an equivalent risk of major trauma death in these two systems of care. In our metropolitan area, we were unable to demonstrate a mortality benefit associated with time.
- 出版日期2011-5
- 单位河北医科大学
