Guenther Stephan, Waydhas Christian, Ose Claudia, Nast-Kolb Dieter
J Trauma. 2003 May;54(5):973-8. doi: 10.1097/01.TA.0000038543.58142.28.
The purpose of this study was to evaluate process and outcome quality of severely injured patients admitted during on-call (OC) versus regular trauma service (RS).
This was a prospective and multicentric analysis of the Trauma Registry of the German Trauma Society. Patients were evaluated if directly admitted from the scene of accident with an Injury Severity Score of > 15 and if alive on arrival at the emergency department.
Seventy percent of patients were admitted during OC; these patients were significantly younger. Blunt trauma predominated, with a 95% incidence. Falls from great heights were significantly more frequent during RS, whereas motor vehicle crashes predominated during OC. No differences were found for emergency department management (e.g., time to abdominal ultrasound, chest radiograph, or cranial computed tomography). However, time to admission to the intensive care unit was substantially longer during RS. No significant differences were found for outcome parameters such as length of intensive care unit stay, hospitalization time, incidence of organ failure, or mortality.
This study demonstrates a constant quality of care provided 24 hours per day, 7 days per week in the participating hospitals. Differences within individual trauma centers were not compared and need to be assessed by internal quality management.
本研究旨在评估在值班期间（OC）与常规创伤服务（RS）期间收治的重伤患者的过程质量和结局质量。
这是一项对德国创伤协会创伤登记处的前瞻性多中心分析。对那些从事故现场直接入院且损伤严重度评分>15分、到达急诊科时仍存活的患者进行评估。
70%的患者在值班期间入院；这些患者明显更年轻。钝性创伤占主导，发生率为95%。在常规创伤服务期间，从高处坠落的情况明显更频繁，而在值班期间机动车碰撞占主导。在急诊科处理方面（如腹部超声、胸部X线或头颅计算机断层扫描的时间）未发现差异。然而，在常规创伤服务期间，入住重症监护病房的时间显著更长。在结局参数方面，如重症监护病房住院时间、住院时间、器官衰竭发生率或死亡率，未发现显著差异。
本研究表明，参与研究的医院每周7天、每天24小时提供的护理质量恒定。未对各个创伤中心内部的差异进行比较，需要通过内部质量管理进行评估。
