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IVENA eHealth®で病院前のトラウマの割り当てを評価する
Philipp Faul1, Daniela Neubecker2, Uwe Schweigkofler3
1Department of Trauma and Orthopedics, BG Trauma Center Frankfurt, Friedberger Landstr. 430, 60389, Frankfurt Am Main, Germany. Philipp.Faul@BGU-Frankfurt.de.
まとめ
IVENA eHealth®システムは,緊急医療サービス (EMS) のトラウマ患者の配分に役立ちますが,正確さは異なります. 病院前診断の改善とリアルタイムのデータの統合は 患者の改善に不可欠です
科学分野:
- 緊急 医療
- 医療情報学
- トラウマ 手術
背景:
- 効果的な緊急トラウマケアには 症例数が増加し 資源が限られているため 課題があります
- 正確な病院前診断と病院配分は トラウマ患者のアウトカムにとって重要です
- IVENA eHealth®は 病院のリアルタイム・キャパシティに基づいて 緊急医療と患者の割り当てを調整するための デジタルプラットフォームです
研究 の 目的:
- IVENA eHealth®による病院前トラウマ患者の割り当てと実際の臨床治療経路との一致性を分析する.
- IVENA eHealth®のトリアージカテゴリーの臨床的正確性を評価する.
主な方法:
- 2018年のレベル1のトラウマセンターへの紹介に関する単一センターの遡及研究.
- 重症度カテゴリー1 (SC1) または重症度カテゴリー2 (SC2) の多重傷害,TBI,胸部,または骨盤のトラウマを疑う患者の分析.
- 病院前重症カテゴリー (SC) と入院タイプを比較し,過量検診と過少検診率,感度,特異性,陽性予測値 (PPV) を計算する.
主要な成果:
- SC1のトリアージの精度は64. 08%で35. 92%の過剰トリアージ;SC2は55. 61%の過剰トリアージと2. 24%の不足トリアージであった.
- 特にポリトラウマとTBIでは,病院前と退院後の診断の間で頻繁に不一致が観察されました.
- SC1分類では94. 01%の感度と64. 08%のPPVが示され,ICUへの入院率はわずか64. 08%であった.
結論:
- IVENA eHealth®は,構造化された患者配分をサポートしていますが,SC1とSC2の配分の精度は変動しています.
- 差異は,現在の病院前評価の限界と重症度コードの仮定を再評価する必要性を強調しています.
- 病院前プロトコルの最適化,リアルタイムのデータの統合,EMS訓練の強化により,配分の正確性が向上します.
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