Calleary J G, el-Nazir A K, el-Sadig O, Carolan P E, Joyce W P
Department of General and Vascular Surgery, Cavan/Monaghan General Hospital, Ireland.
Ir J Med Sci. 1999 Apr-Jun;168(2):93-8. doi: 10.1007/BF02946472.
In December of 1995 a system of trauma care based on Advanced Trauma Life Support (ATLS) principles was instituted to assess the impact of such principles on trauma care in a rural general hospital setting. This audit reviews the results over a 2 yr period to December 1997. All patients admitted with major trauma (i.e. with life threatening or potentially life threatening injuries) to Cavan General Hospital (CGH) were eligible for inclusion. This numbered 70 patients admitted (for at least 3 days), or who were transferred after resuscitation and stabilization as well as inpatient deaths. Twenty-seven patients who died prior to admission are also reviewed. The endpoints assessed were death, disability and survival 3 months post-accident. Based on injury severity scores 7 per cent of cases suffered fatal non-survivable injury, 20-30 per cent had very serious injury with an overall mortality rate of 17 per cent. The predicted mortality rate was 30 per cent. One-third had their full treatment at CGH with a 76 per cent survival rate. The other two-thirds were transferred for specialist intervention with an overall survival of 80 per cent, a disability rate of 16 per cent and a mortality rate of 4 per cent. No patient died during transportation.
1995年12月，一套基于高级创伤生命支持（ATLS）原则的创伤护理系统开始实施，以评估这些原则对农村综合医院创伤护理的影响。本次审计回顾了截至1997年12月的两年期间的结果。所有因重大创伤（即危及生命或可能危及生命的损伤）入住卡万综合医院（CGH）的患者均符合纳入标准。这包括70名入院（至少3天）的患者，或在复苏和稳定后被转运的患者以及住院死亡患者。还对27名入院前死亡的患者进行了审查。评估的终点是事故后3个月的死亡、残疾和存活情况。根据损伤严重程度评分，7%的病例遭受致命的不可存活损伤，20%-30%的病例有非常严重的损伤，总死亡率为17%。预测死亡率为30%。三分之一的患者在CGH接受了全面治疗，存活率为76%。另外三分之二的患者被转运接受专科干预，总存活率为80%，残疾率为16%，死亡率为4%。没有患者在转运过程中死亡。
