Ingham Clark C L, Tabone-Vassallo M
Department of Accident and Emergency, North Middlesex Hospital, Edmonton, London, UK.
Br J Surg. 1991 Feb;78(2):230-3. doi: 10.1002/bjs.1800780234.
A retrospective review of all patients with major trauma admitted to a busy suburban district hospital was conducted over a 1-year period. Outcome for each patient was assessed using the TRISS system which calculates the probability of survival based on anatomical extent of injury and degree of physiological disturbance at the time of admission. Thirty-nine patients were admitted following major trauma, of whom nine died. Seven of the deaths were in patients with a greater than 50 per cent chance of survival according to the TRISS system. In contrast, four patients survived who had a greater than 50 per cent chance of death. Details of these 11 cases are given. The numbers of patients who were referred to neurosurgeons and cardiothoracic surgeons in regional specialist centres were recorded, as was the relative contribution of general and orthopaedic surgeons in our own hospital. We conclude that, in the absence of specialized trauma centres, a reasonable standard of care for patients who have sustained major trauma can be delivered in a district general hospital.
对一家繁忙的郊区区级医院收治的所有严重创伤患者进行了为期1年的回顾性研究。使用TRISS系统评估每位患者的预后，该系统根据损伤的解剖范围和入院时的生理紊乱程度计算生存概率。39例患者因严重创伤入院，其中9例死亡。根据TRISS系统，7例死亡患者的生存几率超过50%。相比之下，4例生存患者的死亡几率超过50%。给出了这11例病例的详细情况。记录了转诊至地区专科中心的神经外科医生和心胸外科医生的患者数量，以及我院普通外科医生和骨科医生的相对贡献。我们得出结论，在没有专门创伤中心的情况下，区级综合医院可以为严重创伤患者提供合理的护理标准。
