死亡率与四肢创伤相关,并将患者转移到更高水平的护理
Aldin Malkoc1, Xinfei Miao2, Kathryn Pillai2
1Department of Surgery, Arrowhead Regional Medical Center, Colton, USA.
Annals of medicine and surgery (2012)
|November 11, 2024
概括
将患者转移到更高级别的创伤中心与死亡率的增加有关,特别是在严重受伤的人群中. 早期包装红细胞 (pRBC) 输血对于创伤患者的生存至关重要.
科学领域:
- 创伤外科 手术 创伤外科
- 医疗保健管理的管理
- 患者研究成果研究结果
背景情况:
- 医疗保健成本上升和医疗补助补偿金减少对创伤中心的生存构成了挑战.
- 由于资源限制,将患者转移到更高级别的护理中心是常见的.
- 以前的研究表明,与成本相关的情况对创伤中心可行性的不利影响.
研究的目的:
- 评估患者转移到更高级别医疗中心的情况与死亡率之间的关系.
- 确定与创伤患者死亡率增加相关的因素.
- 评估转移状态对创伤登记册队列结果的影响.
主要方法:
- 对19417名创伤患者进行了回顾性观察队列研究.
- 7,132名患者的倾向匹配分析 (1:1) (直接与转移).
- 多变量后勤回归分析伤害严重程度,输血和转移状态.
主要成果:
- 总体死亡率为非转移患者中的3%,而转移患者中的4% (P<0.001).
- 较高的伤害严重性得分 (OR 2.351) 和缺乏早期包装红细胞 (pRBC) 输血 (OR 6.852) 显著增加了死亡率.
- 在未转移 (88%) 和转移 (82%) 患者 (P<0.001) 中,形伤害更为常见.
结论:
- 患者转移到更高级别创伤中心的状态与死亡率的增加有关.
- 较高的伤害严重程度和延迟的PRBC输血是死亡率的关键预测因素.
- 创伤患者转移对患者的结果有重大影响,需要进一步调查.
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