用于创伤患者的筛查实验室检查和放射学检查效用低且不具有成本效益。
Screening laboratory and radiology panels for trauma patients have low utility and are not cost effective.
作者信息
Tasse James L, Janzen Mark L, Ahmed Naveed A, Chung Raphael S
机构信息
Division of Trauma and Surgical Critical Care, Department of General Surgery, Huron Hospital, Cleveland Clinic Health System, Cleveland, Ohio, USA.
出版信息
J Trauma. 2008 Nov;65(5):1114-6. doi: 10.1097/TA.0b013e318184b4f2.
BACKGROUND
Routine laboratory and radiology panels as part of the initial evaluation of the trauma patient are prevalent practices. This is a study of utility and cost effectiveness of this practice.
METHODS
During a 3-month period, trauma panels were analyzed for cost and impact on patient care in our institution.
RESULTS
Four hundred ten consecutive patients had 3,982 studies (cost $417,839) performed of which 1,292 (cost $114,753) were abnormal and only 253 (cost $36,703) were clinically contributory.
CONCLUSIONS
Routine panels are not useful or cost effective. Negative results contribute little to management. Selective and targeted studies should be indicated by the secondary survey, and may result in substantial cost savings ($1,500,000 per year at our institution).
背景
作为创伤患者初始评估的一部分，常规实验室检查和影像学检查普遍存在。这是一项关于这种做法的实用性和成本效益的研究。
方法
在3个月的时间里，对我们机构中创伤检查的成本和对患者护理的影响进行了分析。
结果
410例连续患者进行了3982项检查（费用为417,839美元），其中1292项（费用为114,753美元）异常，只有253项（费用为36,703美元）对临床有帮助。
结论
常规检查既无用处也不具有成本效益。阴性结果对治疗贡献不大。应通过二次评估来选择和针对性地进行检查，这可能会大幅节省成本（在我们机构每年节省150万美元）。
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