创伤性内血瘤疏散的时间:当代标准和改进空间
Michael P Merakis1, Natasha Weaver1, Angela Fischer1
1John Hunter Hospital & University of Newcastle, Newcastle, NSW, Australia.
概括
创伤性内血瘤 (TICH) 的手术干预时间接近5小时. 在过去的13年里,直接进入创伤中心的患者在TICH疏散过程中经历了更长的延迟,这影响了患者的治疗结果.
科学领域:
- 神经外科 神经外科
- 创伤外科 手术 创伤外科
- 紧急医疗 紧急医疗
背景情况:
- 创伤性内血瘤 (TICH) 是一个重要的神经外科紧急情况,与高死亡率和发病率有关.
- 及时的手术减压是影响TICH患者结果的关键,可修改的因素.
- 不一致的操作时间报告使TICH管理中的护理质量评估复杂化.
研究的目的:
- 提供有关TICH疏散时间的最新数据.
- 在定义的创伤系统内分析TICH疏散时间的长期趋势.
- 确定影响TICH外科干预延迟的因素.
主要方法:
- 一项为期13年的回顾性队列研究 (2021年结束) 对为TICH进行紧急骨切除/骨切除的患者进行了研究.
- 数据收集包括人口统计,伤害严重程度 (ISS,AIS头部),以及从伤害到操作干预的关键时间框架.
- 分析涉及子组比较 (多创伤与孤立头部伤害,直接入院与转移,幸存者与非幸存者) 和伤害到OR时间的线性回归.
主要成果:
- 该研究确定了78名TICH患者,中位数伤害至手术时间为4.88小时.
- 直接进入创伤中心的患者在13年研究期间 (p=0.04) 显示,手术干预的时间在统计学上显著增加.
- 尽管延迟时间越来越长,但在研究期间,死亡率或格拉斯哥结论量表得分没有显著变化.
结论:
- 当代数据表明,TICH的伤害到外科疏散的中位时间接近5小时.
- 在13年的研究期间,观察到一个显著的趋势,即直接入院的操作干预延迟日益增加.
- 这些发现需要对TICH护理途径进行批判性评估,并在创伤系统中进行标准化报告,以改善患者的治疗结果.
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