一家城市创伤中心的15年发展历程：创伤外科医生的未来何去何从？
The 15-year evolution of an urban trauma center: what does the future hold for the trauma surgeon?
作者信息
Engelhardt S, Hoyt D, Coimbra R, Fortlage D, Holbrook T
机构信息
Southern California Kaiser Permanente Medical Group, San Diego Medical Center, California, USA.
出版信息
J Trauma. 2001 Oct;51(4):633-7; discussion 637-8. doi: 10.1097/00005373-200110000-00002.
BACKGROUND
Safer cars, decreased violence, and nonoperative management have changed the trauma patient's nature. We evaluated changes in a Level I trauma center over 15 years and considered their effect on trauma surgeons.
METHODS
From January 1985 through August 1999, 16,799 trauma registry patients were analyzed for mechanism of injury, Injury Severity Score, and procedures.
RESULTS
Mean Injury Severity Score decreased from 15.9 to 10.7 and length of stay fell from 8.0 days to 5.9 days. There were significant decreases in penetrating trauma admissions and percentage of patients with Abbreviated Injury Scale score > 3 for head, chest, and abdomen. Frequency of craniotomy, thoracotomy, and laparotomy dropped dramatically.
CONCLUSION
Significant decreases in injury severity, penetrating violence, and operations have occurred over 15 years. These changes will have profound effects on the practice of trauma surgeons and on surgical education.
背景
更安全的汽车、暴力事件减少以及非手术治疗方法改变了创伤患者的特性。我们评估了一家一级创伤中心在15年中的变化，并考虑了这些变化对外科创伤医生的影响。
方法
对1985年1月至1999年8月期间创伤登记处的16799名患者的受伤机制、损伤严重程度评分及治疗程序进行了分析。
结果
平均损伤严重程度评分从15.9降至10.7，住院时间从8.0天降至5.9天。穿透性创伤入院人数以及头部、胸部和腹部简明损伤定级评分>3的患者百分比显著下降。开颅手术、开胸手术和剖腹手术的频率大幅下降。
结论
在15年中，损伤严重程度、穿透性暴力事件和手术数量均显著下降。这些变化将对外科创伤医生的业务实践及外科教育产生深远影响。
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