一级创伤中心的扩散可能会使患者的结果变得更糟
Michael Zhou1, Taylor W Norton1, Kelsey Rupp1
1Department of Surgery, Resident, University of Arizona College of Medicine - Phoenix, Phoenix, AZ, USA.
The American surgeon
|April 6, 2024
概括
亚利桑那 亚利桑那 亚利桑那
科学领域:
- 创伤护理系统的创伤护理系统
- 公共卫生政策 公共卫生政策
- 紧急医疗 紧急医疗
背景情况:
- 2013年至2020年间,亚利桑那州的创伤系统从7个扩大到13个1级创伤中心 (L1TC).
- 本研究分析了这种L1TC扩散对患者结果的影响,使用了州创伤登记数据.
研究的目的:
- 评估1级创伤中心 (L1TC) 可用性增加对创伤患者死亡率的影响.
- 在创伤系统扩张的背景下,确定死亡率的预测因素.
主要方法:
- 分析了2007-2020年间的成人创伤患者 (年龄≥15岁).
- 数据比较了前扩散 (2007-2012) 和后扩散 (2013-2020) 期间的数据.
- 多变量逻辑回归评估死亡率预测因素,对受伤严重程度,年龄和创伤机制进行子组分析.
主要成果:
- 包括48万多名患者;住院患者死亡率为2.7%.
- 后扩散期看到更多的女性,老年和重创伤患者.
- 调整后的分析显示,后扩散期是死亡的独立预测 (OR: 1.4,CI: 1.3-1.5),除了老年人亚组.
结论:
- 尽管L1TCs翻了一番,但发生了最小的未调整的死亡率降低.
- 增加的L1TC数量独立地与更高的死亡率有关.
- 未来的创伤系统设计应该探索不仅仅是增加L1TC数量的策略.
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