美国创伤护理和枪支伤害死亡率的地理空间访问:全国县级分析
Austin D Williams1, Matthew J Parham, Amelia E Mercado
1From the Division of Trauma and Acute Care Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine (A.D.W., M.J.P., A.E.M., M.D.Z., K.M., C.P.S.), Houston, Texas; and Markey Cancer Center, University of Kentucky (T.B.), Lexington. Kentucky.
The journal of trauma and acute care surgery
|January 14, 2026
概括
长时间前往创伤中心的旅行时间增加了枪支伤害死亡率. 地理空间分析显示,每增加一分钟的运输时间都会增加死亡风险,突出了医疗服务获得的差异.
科学领域:
- 公共卫生 公共卫生
- 流行病学 流行病学
- 创伤护理研究 创伤护理研究
背景情况:
- 在创伤护理获得的地理差异可能会加剧枪支死亡率.
- 美国的创伤系统发展不均,缺乏国家结果评估.
研究的目的:
- 评估到创伤中心的运输时间与全国范围内枪支伤害死亡率之间的联系.
- 确定创伤护理获取的地理差异及其对患者结果的影响.
主要方法:
- 全国,县级横截面流行病学研究 (2014-2023) 446,584枪支伤害.
- 地理空间建模计算了最佳运输时间到I/II级创伤中心.
- 多变量波桑回归分析了运输时间和病例死亡率 (CFR) 之间的关系,并对共变量进行了调整.
主要成果:
- 总体CFR为31.9% (142,555例死亡). 这是一个很好的例子.
- 平均最佳运输时间为30.9分钟.
- 每增加一分钟的运输时间都与6.3%的CFR相对增加有关 (p=0.04).
结论:
- 延长到创伤中心的运输时间显著增加了枪支伤害死亡率.
- 研究结果支持使用地理空间工具进行创伤系统规划,特别是在服务不足的地区.
- 解决地理障碍对于公平的枪支伤害结果至关重要.
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