Larson Jeremy T, Dietrich Ann M, Abdessalam Shahab F, Werman Howard A
Department of Pediatrics, College of Medicine and Public Health, Ohio State University, Columbus, 43205, USA.
J Trauma. 2004 Jan;56(1):89-93. doi: 10.1097/01.TA.0000061163.35582.A5.
The purpose of this study was to compare outcomes of pediatric trauma patients transported by helicopter from the injury scene (IS group) to a trauma center and those transported by air after hospital stabilization (HS group).
A retrospective analysis of pediatric trauma patients (<19 years of age) transported by air ambulance and admitted to a pediatric trauma center was conducted. Outcomes compared were mortality and length of stay. Patients were subdivided into minor (Injury Severity Score [ISS] < 15) and major (ISS > 15) trauma. TRISS analysis was performed to verify the overall quality of the care.
Eight hundred forty-two HS and 379 IS patients were included. The mean age, median ISS, and distribution of penetrating and blunt injuries did not differ significantly between the groups. The overall death rate was significantly lower for the interfacility transfer patients (HS group, 5.5%; IS group, 8.7%; p < 0.05). Mean intensive care unit (ICU) and hospital length of stay did not differ significantly. HS patients with major trauma had significantly less mortality (HS group, 15.5%; IS group, 26.7%; p < 0.05) and shorter mean ICU stays (HS group, 118.3 hours; IS group, 149.1 hours; p < 0.05) than IS major trauma patients. No differences were seen in patients with minor trauma. TRISS analysis showed improved survival for all patients compared with Major Trauma Outcome Study norms.
Retrospective analysis was not able to demonstrate any benefit to direct transport from the scene to a trauma center. Hospital stabilization before transfer by air ambulance may improve survival and shorten ICU stays for patients with major trauma.
本研究的目的是比较从受伤现场由直升机转运至创伤中心的儿科创伤患者（IS组）与在医院病情稳定后经空中转运的患者（HS组）的治疗结果。
对通过空中救护转运并入住儿科创伤中心的儿科创伤患者（<19岁）进行回顾性分析。比较的结果指标为死亡率和住院时间。患者被分为轻伤（损伤严重度评分[ISS]<15）和重伤（ISS>15）。进行TRISS分析以验证整体护理质量。
纳入842例HS患者和379例IS患者。两组之间的平均年龄、ISS中位数以及穿透伤和钝伤的分布无显著差异。机构间转运患者的总体死亡率显著更低（HS组，5.5%；IS组，8.7%；p<0.05）。重症监护病房（ICU）平均住院时间和医院住院时间无显著差异。与IS重伤患者相比，HS重伤患者的死亡率显著更低（HS组，15.5%；IS组，26.7%；p<0.05），ICU平均住院时间更短（HS组，118.3小时；IS组，149.1小时；p<0.05）。轻伤患者未见差异。TRISS分析显示，与重大创伤结局研究标准相比，所有患者的生存率均有所提高。
回顾性分析未能证明从现场直接转运至创伤中心有任何益处。通过空中救护转运前在医院进行病情稳定处理可能会提高重伤患者的生存率并缩短其ICU住院时间。
