离家更近:在IV级创伤中心管理三次以上的肋骨骨折
Adam Lizak1, Anthony Allsbrook, Rebecca Wilde-Onia
1From the Temple University/Temple St. Luke's Medical School (A.L.); and Division of Acute Care Surgical Services, Department of Surgery (A.A., R.W.-O., L.R., R.B., J.C., P.T., R.C., M.A.B.), St. Luke's University Health Network, Bethlehem, Pennsylvania.
The journal of trauma and acute care surgery
|February 25, 2025
概括
新的创伤中心标准减少了肋骨骨折患者的转移. 第四级创伤中心的结果与多重肋骨骨折患者的更高水平中心的结果相似.
科学领域:
- 创伤外科 手术 创伤外科
- 紧急医疗 紧急医疗
- 公共卫生政策 公共卫生政策
背景情况:
- 肋骨骨折是创伤入院的常见原因之一.
- 宾夕法尼亚州的创伤标准在2020年发生了变化,允许第四级中心接收超过三个肋骨骨折的患者.
- 本研究评估了这些患者在IV级中心的治疗结果.
研究的目的:
- 评估入住第四级创伤中心的三次以上没有并发症的肋骨骨折患者的结果.
- 评估宾夕法尼亚州创伤系统标准修订对患者转移率和结果的影响.
- 为了比较IV级和I/II级创伤中心对多重肋骨骨折患者的结果.
主要方法:
- 对1070名隔离肋骨骨折患者 (2018-2022) 的回顾性分析.
- 基于相对于2020年标准变化的入院时间的患者分层.
- 1:1的倾向分数匹配,用于比较IV级和I/II级中心对>3次骨折的患者的结果.
主要成果:
- 观察到隔离肋骨骨折转移率的显著降低后标准变化 (56%到21%).
- >3个肋骨骨折的患者与≤3个骨折的患者相比,住院时间和死亡率相似.
- 倾向匹配分析显示,IV级和I/II级中心之间的年龄,受伤特征,停留时间或死亡率没有显著差异.
结论:
- 修订的州入院标准成功减少了多重肋骨骨折患者的转移.
- 第四级创伤中心在匹配的患者中提供与I/II级中心相似的结果,这些患者有>3个孤立肋骨骨折.
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