Góngora E, Acosta J A, Wang D S, Brandenburg K, Jablonski K, Jordan M H
Department of Surgery, Burns/Trauma Section, Washington Hospital Center, Washington, DC, USA.
J Trauma. 2001 Nov;51(5):854-9. doi: 10.1097/00005373-200111000-00006.
The objective of this study was to compare the injuries and outcomes of ejected victims who reached a Level I trauma center with nonejected MVC occupants.
Data from 6,909 MVC victims admitted to a Level I trauma center, over a 91/2-year period, were retrospectively reviewed. Three mutually exclusive groups were studied: ejected, nonejected nonrestrained, and nonejected restrained.
The patient distribution was as follows: ejected 6.4% (n = 443), nonrestrained 50.1% (n = 3,461), and restrained 43.5% (n = 3,005). Ejected patients were younger, required ICU care more frequently, and a higher percentage were males compared with nonrestrained or restrained patients. Injury Severity Score (ISS) and length of stay (LOS) were significantly higher in ejected patients. Ejected patients suffered more injuries per anatomic region, and had a higher number of severe injuries in the head and neck region. The overall in-hospital mortality was 3.9% (272/6,909), and 10.8% (48/443) for the ejected group. The incidence of restrained patients increased during the study period but was not associated with a change in the incidence of ejected patients.
Patients who were ejected after motor vehicle collisions were more severely injured and had a worse outcome than those not ejected. Efforts should be concentrated on enforcement and enactment of better seat belt laws, as well as the development of new strategies that will prevent ejection regardless of occupant behavior.
本研究的目的是比较送达一级创伤中心的被弹出车外的受害者与未被弹出的机动车碰撞事故驾乘人员的损伤情况及预后。
回顾性分析了9年半时间里收治于一级创伤中心的6909例机动车碰撞事故受害者的数据。研究了三个相互排斥的组：被弹出车外者、未被弹出且未系安全带者、未被弹出且系安全带者。
患者分布如下：被弹出车外者6.4%（n = 443），未系安全带者50.1%（n = 3461），系安全带者43.5%（n = 3005）。与未系安全带或系安全带的患者相比，被弹出车外的患者更年轻，更频繁地需要重症监护病房护理，且男性比例更高。被弹出车外的患者损伤严重程度评分（ISS）和住院时间（LOS）显著更高。被弹出车外的患者每个解剖区域的损伤更多，头颈部严重损伤的数量也更多。总体院内死亡率为3.9%（272/6909），被弹出车外组为10.8%（48/443）。在研究期间，系安全带患者的比例增加，但与被弹出车外患者的比例变化无关。
机动车碰撞事故后被弹出车外的患者比未被弹出的患者受伤更严重，预后更差。应集中精力加强和制定更好的安全带法律，以及制定新的策略，无论驾乘人员行为如何，都能防止被弹出车外。
