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美国各地严重受伤的创伤患者的二次低分组

Jacoby R Bryce¹, Stephanie E Iantorno², Jack H Scaife¹

¹University of Utah, School of Medicine.

Journal of the American College of Surgeons

|August 19, 2025

概括

超过一半的严重受伤的创伤患者未经查,并没有转移到更高级别的创伤中心. 老年,公共保险和医院位置预测不转移,突出需要包容性创伤系统.

科学领域:

创伤外科手术创伤外科
紧急医疗紧急医疗
医疗保健服务研究医疗服务研究

背景情况:

对于严重受伤的患者来说,二次分拣至关重要,将他们引导到具有更高资源的创伤中心,以改善生存.
很大一部分这些患者没有转移,这表明创伤护理系统中存在潜在的缺口.

研究的目的:

量化严重受伤患者的数量,而不是转移到更高层次的创伤护理.
确定患者和医院一级预测不转移的因素.

主要方法:

2019年全国紧急情况部门样本的回顾性分析.
包括成人创伤患者,受伤严重程度评分 (ISS) >15最初呈现给III级或非创伤中心 (NTC).
多变量通用线性模型确定了非转移的预测因素.

主要成果:

58%的符合条件的患者 (84,695/146,816) 没有转移,这意味着二次低选.
患者因素:年龄增加 (≥80) 和公共保险 (医疗保险,医疗补助) 预计不会转移.
医院因素:III级指定和大都市位置强烈预测不转移.

结论:

在美国,三分之一的严重受伤的创伤患者最初在较低级别的设施接受治疗,超过一半的人没有被转移.
医院的特点,如大都市位置和III级指定,是不转移的关键预测因素.
调查结果倡导包容性国家创伤系统,将所有急症医院整合到注册表和质量改善工作中.

关键词:

二次次序下划分的第二次划分.其他非创伤中心.重新选,重新进行选.创伤系统创伤系统

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