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紧急医疗个人临床医生创伤患者中的体积和死亡率创伤患者中的死亡率

Jamison Beiriger¹, Christian Martin-Gill², David S Silver¹

¹Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

|February 18, 2026

概括

紧急医疗服务 (EMS) 临床医生的患者数量较高与创伤患者的早期死亡率降低有关. 这一发现强调了临床医生的经验在改善创伤护理结果方面的重要性.

科学领域:

紧急医疗紧急医疗
创伤外科手术创伤外科
公共卫生公共卫生

背景情况:

最初的紧急医疗服务 (EMS) 治疗对严重受伤的患者的结果产生了重大影响.
有效的出血控制,血液制品的使用和遵守创伤性脑损伤指南对于减少创伤相关的发病率和死亡率至关重要.
在高急性非创伤情形中,医院前临床医师的经验与改善患者的治疗结果相关.

研究的目的:

调查个人EMS临床医生每年处理的创伤患者数量与患者结果之间的关联.
为了确定更高的临床医生在管理创伤病例的经验是否与降低的死亡率相关.
评估EMS临床医师数量和创伤护理中的特定质量指标之间的关系.

主要方法:

对前性观察队列研究的二次分析,创伤和紧急服务 (LITES) 相关调查任务令1 (2017-2021).
纳入标准:严重受伤的患者 (伤害严重性评分≥9) 通过空中或地面的EMS运送到创伤中心.
统计分析涉及患者级风险调整回归模型,以评估EMS机组人员平均3年成人创伤量和死亡率之间的关联,以及气道成功指标和输管量.

主要成果:

总共分析了6769个患者与临床医生的相互作用,涉及359名临床医生和3649名患者.
每个EMS工作人员每年增加5名成年创伤患者,与6小时死亡率下降10% (aOR,0.899) 和住院死亡率下降2.6% (aOR,0.974) 相关.
较高的临床医生创伤量与减少现场时间和增加无并发症输管成功率相关;然而,非创伤量和多年的经验没有显示出与死亡率的显著关联.

结论:

每位EMS临床医生的患者数量较高与创伤患者的早期死亡率较低有关.
研究结果表明,基于临床医师数量的优化人员配置和教育策略可能会提高创伤护理.
需要进一步的研究来探索这些协会,并为EMS提供商建立绩效基准.

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