了解创伤住院对非手术服务的影响
Jennie S Kim1, Morgan Schellenberg1, Sixta Navarette1
1Division of Acute Care Surgery, LAC + USC Medical Center, University of Southern California, Los Angeles, CA, USA.
The American surgeon
|June 1, 2023
概括
对创伤患者的非手术入院 (NSAs),特别是那些严重受伤的人 (伤害严重程度评分> 9),是适当的,并没有对护理产生负面影响. 这种方法对于管理老龄化人口和日益增长的老年创伤病例至关重要.
科学领域:
- 创伤外科 手术 创伤外科
- 创伤护理标准 创伤护理标准
- 老年创伤的治疗方法
背景情况:
- 美国外科医生协会创伤委员会 (ACS COT) 制定了创伤中心的标准,包括对非手术入院的限制.
- 提高性能需要对NSA进行审查,特别是对于伤害严重程度评分 (ISS) 大于9的患者.
研究的目的:
- 评估创伤患者的非手术入院 (NSAs) 的适当性.
- 评估在创伤护理中非手术入院所产生的任何潜在的临床影响.
主要方法:
- 在ACSCOT验证的1级创伤中心对创伤患者的回顾性查.
- 包含ISS>9的非手术入院,以进行详细审查.
- 创伤医疗主任和副创伤医疗主任对适当性和临床影响进行评估.
主要成果:
- 40名患者 (平均年龄54岁,平均ISS 19) 符合标准,大多数患者因地面落 (GLF) 遭受创伤性脑损伤 (TBI).
- 所有NSA都涉及外科服务的评估,主要是神经外科和创伤外科.
- 尽管死亡率为40% (主要是TBI),但所有NSA都被认为是适当的,没有负面的临床影响.
结论:
- 所有审查的非手术入院都是适当的,并且不会影响患者的护理.
- 非手术入院往往涉及老年患者,他们的头部受伤来自地面的落.
- 对NSA进行外科咨询可能对于有效管理日益增加的老年创伤患者入院至关重要.
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