一级创伤中心的骨盆骨折：以色列不断发展的创伤系统疗效的一个测试案例。

Pelvic fractures in a level I trauma center: a test case for the efficacy of the evolving trauma system in Israel.

作者信息

Barzilay Yair, Liebergall Meir, Safran Ori, Khoury Amal, Mosheiff Rami

机构信息

Department of Orthopedic Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.

出版信息

Isr Med Assoc J. 2005 Oct;7(10):619-22.

PMID:16259338

Abstract

BACKGROUND

Pelvic fracture is a severe and life-threatening injury that requires treatment by a dedicated team. One of the goals of a nationwide trauma system is to provide appropriate medical care for such injuries.

OBJECTIVES

To use pelvic fractures as a test case for the efficiency of the Israeli trauma system, as reflected in the experience of our medical center.

METHODS

Data were obtained from the medical charts of all cases of pelvic fractures admitted to our medical center between 1987 and 1999. We obtained demographic data, information on the cause of injury, fracture classification, co-injuries and Injury Severity Score, treatment strategies, and mortality rate.

RESULTS

Altogether, 808 patients with pelvic injuries were treated in our medical center. The most common cause of injury was motor vehicle accidents (51%). Pelvic fractures without acetabular involvement were diagnosed in 58% of patients and isolated acetabular fractures in 32%, while 10% sustained combined injuries to the pelvic ring and the acetabulum. The overall rate of operative stabilization was 34%. The majority of patients had associated injuries, mostly additional musculoskeletal injuries. Altogether, 13% were referred from Level II/III trauma centers. We observed an increase in the total number of local admissions, in the percentage of referred patients and in the percentage of operated patients during the study period. The observed mortality rate was 5%.

CONCLUSIONS

Our results show a more than twofold increase in the percentage of referred patients following the designation of a Level I trauma center. These referrals are due not only to the designation as a Level I trauma center, but also to the presence of a dedicated team of pelvic fracture specialists, available 24 hours a day. In addition, a larger percentage of patients undergo surgery for internal fixation of pelvic fractures, in accordance with current worldwide trends.

摘要

背景

骨盆骨折是一种严重且危及生命的损伤，需要由专业团队进行治疗。全国创伤系统的目标之一是为这类损伤提供适当的医疗护理。

目的

以骨盆骨折作为以色列创伤系统效率的测试案例，这体现在我们医疗中心的经验中。

方法

数据取自1987年至1999年间收治于我们医疗中心的所有骨盆骨折病例的病历。我们获取了人口统计学数据、损伤原因信息、骨折分类、合并伤和损伤严重程度评分、治疗策略以及死亡率。

结果

我们医疗中心共治疗了808例骨盆损伤患者。最常见的损伤原因是机动车事故（51%）。58%的患者被诊断为无髋臼受累的骨盆骨折，32%为孤立性髋臼骨折，10%的患者骨盆环和髋臼合并损伤。手术稳定治疗的总体比例为34%。大多数患者有合并伤，主要是其他肌肉骨骼损伤。共有13%的患者是从二级/三级创伤中心转诊而来。在研究期间，我们观察到本地收治患者总数、转诊患者百分比和手术患者百分比均有所增加。观察到的死亡率为5%。