Lemos David, Nilssen Eric, Khatiwada Bikalpa, Elder Graham M, Reindl Rudolph, Berry Gregory K, Harvey Edward J
McGill University Health Centre/ McGill University, Montréal, Que.
Can J Surg. 2009 Apr;52(2):87-91.
A general trend in orthopedic traumatology is the advent of daily, dedicated orthopedic trauma theatres. Availability of trauma theatres is believed to decrease morbidity and mortality, but this remains unproven. We performed a retrospective review comparing morbidity and mortality outcomes at a single institution before and after the establishment of a dedicated trauma room. The purpose was to determine whether a change in outcomes occurred for a single routine procedure with known outcome expectations (hemiarthroplasty of the hip after femoral neck fracture) with the implementation of a designated trauma theatre.
We examined a cohort of 457 elderly patients (245 before and 212 after trauma theatre implementation) who underwent hemiarthroplasty for displaced low-energy subcapital hip fractures.
Patients in both groups were similar in terms of age, sex ratio and ASA classification. We found statistically significant differences favouring the dedicated trauma room system for postoperative morbidity. Despite this outcome, the average time to surgery for these patients significantly increased. We noted no difference in mortality between the 2 groups.
The hip fracture population can be treated safely in the context of dedicated trauma room time; however, there needs to be prioritization of hip fractures in a tertiary care centre or other trauma cases will tend to take precedence.
骨科创伤学的一个总体趋势是出现了每日专用的骨科创伤手术室。创伤手术室的可用性被认为可降低发病率和死亡率，但这一点尚未得到证实。我们进行了一项回顾性研究，比较了在设立专用创伤室前后，单一机构的发病率和死亡率结果。目的是确定在实施指定创伤手术室后，对于一种具有已知预期结果的常规手术（股骨颈骨折后髋关节半关节置换术），结果是否发生了变化。
我们研究了一组457例老年患者（创伤手术室实施前245例，实施后212例），这些患者因低能量移位型股骨颈下骨折接受了髋关节半关节置换术。
两组患者在年龄、性别比例和美国麻醉医师协会（ASA）分级方面相似。我们发现，在术后发病率方面，支持专用创伤室系统的差异具有统计学意义。尽管有这一结果，但这些患者的平均手术时间显著增加。我们注意到两组之间的死亡率没有差异。
在专用创伤室时间的背景下，髋部骨折患者可以得到安全治疗；然而，在三级护理中心需要优先处理髋部骨折，否则其他创伤病例往往会优先得到处理。
