空中或地面运输到重症监护复苏室:这真的很重要吗?
Quincy K Tran1, Anastasia Ternovskaia2, Nelson Chen3
1Program in Trauma, The R Adam Cowley Shock Trauma Center, University of Maryland School of Medicine, Baltimore, MD; The Research Associate Program in Emergency Medicine and Critical Care, Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD; Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD.
对重症患者的航空运输没有显著影响医院死亡率或住院时间. 然而,空中运输导致了更快的到达,并增加了紧急手术的可能性,以转移重症监护复苏单位.
科学领域:
- 关键护理医学 关键护理医学
- 紧急医疗 紧急医疗
- 运输 运输 物流 后勤
背景情况:
- 危急病患者往往需要转移到专门的中心.
- 对于这些患者来说,最佳的运输方法 (空中或地面) 尚未确立.
- 高级护理中心对于先进的干预措施至关重要.
研究的目的:
- 确定航空运输是否与转移到专业重症监护复苏单位 (CCRU) 的重症患者的较低死亡率有关.
- 为了比较医院死亡率,住院时间和空中和地面运输之间的手术室 (OR) 时间.
主要方法:
- 对2018年转移到CCRU的成年患者进行了回顾性研究.
- 最佳 1:2 倾向性得分匹配被用来比较空中和地面运输群体.
- 主要结局:医院死亡率. 二次结果:停留时间,到手术室的时间.
主要成果:
- 航空运输的198名患者与地面运输的382名患者相匹配;没有显著的人口或结果差异.
- 医院死亡率相似:空气生存率为83%,地面生存率为80% (P = .46).
- 航空运输导致CCRU的到达速度更快 (127分钟与223分钟相比,P<.001),并在12小时内进行紧急手术的比例更高 (30%与17%相比,P<.001).
结论:
- 运输方式 (空中与地面) 与重症患者的住院死亡率或住院时间长度没有显著关联.
- 航空运输促进了更快地获得专业护理和紧急外科干预的机会.
- 进一步的研究可能会探索从航空运输中受益的特定患者子组.
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