国际创伤护理：以色列耶路撒冷与美国弗吉尼亚州费尔法克斯县的比较

DeKeyser Freda, Avitzour Malka, Watts Dorraine Day, Trask Arthur L, Muggia-Sullam Michael

Hadassah-Hebrew University School of Nursing, Jerusalem, Israel.

Isr Med Assoc J. 2002 Feb;4(2):103-8.

BACKGROUND

Trauma is viewed by many as a global problem. The phenomenon of similar outcomes within differing healthcare delivery systems can illuminate the strengths and weaknesses of various trauma systems as well as the effects of these characteristics on patient outcome.

OBJECTIVES

To compare and contrast demographic and injury characteristics as well as patient outcomes of two urban/suburban trauma centers, one in Israel and the other in the United States.

METHODS

Study data were obtained from the trauma registries of two trauma centers. Demographic variables, injury characteristics and outcomes were compared statistically between registries.

RESULTS

Significant differences between the registries were found in demographic variables (age), injury characteristics (Injury Severity Score and mechanism of injury), and outcome (mortality and length of stay). Age and Injury Severity Score were found to be significant predictors of outcome in both registries. The Glasgow Coma Score was found to contribute to patient outcomes more than the ISS. Differences were found in the relative impact of injury and demographic factors on outcomes between the registries. After including the influence of these factors on patient outcomes, significant differences still remained between the outcomes of the trauma centers.

CONCLUSIONS

Despite possible explanations for these differences, true comparisons between centers are problematic.

背景

许多人认为创伤是一个全球性问题。不同医疗服务体系中出现相似结果的现象能够揭示各种创伤系统的优缺点，以及这些特征对患者预后的影响。

目的

比较和对比以色列和美国的两个城市/郊区创伤中心的人口统计学和损伤特征以及患者预后。

方法

研究数据来自两个创伤中心的创伤登记处。对登记处之间的人口统计学变量、损伤特征和预后进行统计学比较。

结果

登记处之间在人口统计学变量（年龄）、损伤特征（损伤严重程度评分和损伤机制）和预后（死亡率和住院时间）方面存在显著差异。年龄和损伤严重程度评分在两个登记处均被发现是预后的重要预测因素。格拉斯哥昏迷评分对患者预后的影响比损伤严重程度评分更大。登记处之间在损伤和人口统计学因素对预后的相对影响方面存在差异。在纳入这些因素对患者预后的影响后，创伤中心的预后之间仍存在显著差异。