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严重受伤的创伤患者的低分泌量
Kemp Anderson1, Morgan Schellenberg1, Natthida Owattanapanich1
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
许多严重受伤的创伤患者 (ISS ≥25) 没有得到充分的诊断,特别是那些胸部受伤的患者. 这些未得到充分检测的患者面临着高率的突发干预和死亡率,这突显了改善现场鉴定的必要性.
科学领域:
- 创伤外科 手术 创伤外科
- 紧急医疗 紧急医疗
- 公共卫生 公共卫生
背景情况:
- 美国外科医生学院 (ACS) 制定了创伤组激活 (TTA) 标准,以识别严重受伤的患者.
- 严重不足的 (SU) 患者不符合TTA标准,但受伤严重程度得分 (ISS) ≥25,风险不良结果.
研究的目的:
- 划分患者人口统计,损伤模式和严重不足的 (SU) 患者的结果.
主要方法:
- 在ACS认证的1级创伤中心对25以上ISS的创伤患者的回顾性审查 (11/2015-03/2022).
- 不包括转机和私人车辆运输.
- 符合TTA标准 (适当分组,AT) 的患者与不符合标准 (SU) 的患者进行了比较.
主要成果:
- 1653名患者符合标准:其中1375名 (83%) 是AT,278名 (17%) 是SU.
- 与AT患者相比,SU患者年龄较大 (47岁与36岁),主要患有形创伤 (96%),并患有较低的ISS (29岁与32岁).
- 胸部损伤最常见的是SU患者 (64%). 在SU患者中观察到高新兴输管率 (12%),手术率 (21%) 和血管栓塞率 (8%),死亡率为14%.
结论:
- 严重受伤患者中很大一部分 (ISS ≥25) 没有得到足够的查,特别是那些胸部受伤的患者.
- 没有充分查的患者经历了高率的紧急干预和住院死亡率.
- 改善苏患者的现场识别是至关重要的,因为他们可能从创伤团队激活 (TTA) 中受益.
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