Nijboer Johanna M M, Wullschleger Martin E, Nielsen Susan E, McNamee Anitia M, Lefering Rolf, ten Duis Hendrik-Jan, Schuetz Michael A
Department of Surgery - Trauma Service, Princess Alexandra Hospital, Brisbane, Australia.
ANZ J Surg. 2010 Mar;80(3):145-50. doi: 10.1111/j.1445-2197.2010.05210.x.
The allocation of a trauma network in Queensland is still in the developmental phase. In a search for indicators to improve trauma care both locally as state-wide, a study was carried out comparing trauma patients in Queensland to trauma patients in Germany, a country with 82.4 million inhabitants and a well-established trauma system.
Trauma patients > or =15 years of age, with an Injury Severity Score (ISS) > or = 16 admitted to the Princess Alexandra Hospital (PAH) and to the 59 German hospitals participating in the Trauma Registry of the German Society for Trauma Surgery (DGU-G) during the year 2005 were retrospectively identified and analysed.
Both cohorts are comparable when it comes to demographics and injury mechanism, but differ significantly in other important aspects. Striking is the low number of primary admitted patients in the PAH cohort: 58% versus 83% in the DGU-G cohort. PAH patients were less physiologically deranged and less severely injured: ISS 25.2 +/- 9.9 versus 29.9 +/- 13.1 (P < 0.001). Subsequently, they less often needed surgery (61% versus 79%), ICU admission (49% versus 92%) and had a lower mortality: 9.8% versus 17.9% of the DGU-G cohort.
Relevant differences were the low number of primary admissions, the lesser severity of injuries, and the low mortality of the patients treated at the PAH. These differences are likely to be interrelated and Queensland's size and suboptimal organization of trauma care may have played an important role.
昆士兰州创伤网络的分配仍处于发展阶段。为了寻找可在本地及全州范围内改善创伤护理的指标，开展了一项研究，将昆士兰州的创伤患者与德国的创伤患者进行比较。德国有8240万人口，拥有完善的创伤系统。
回顾性确定并分析了2005年期间入住亚历山德拉公主医院（PAH）的15岁及以上、损伤严重度评分（ISS）≥16的创伤患者，以及参与德国创伤外科学会创伤登记处（DGU-G）的59家德国医院的创伤患者。
两组在人口统计学和损伤机制方面具有可比性，但在其他重要方面存在显著差异。引人注目的是，PAH组初次入院患者数量较少：58%，而DGU-G组为83%。PAH患者的生理紊乱程度较轻，损伤程度也较轻：ISS为25.2±9.9，而DGU-G组为29.9±13.1（P<0.001）。随后，他们需要手术的频率较低（61%对79%）、入住重症监护病房的频率较低（49%对92%），死亡率也较低：为DGU-G组的9.8%对17.9%。
相关差异在于PAH的初次入院患者数量少、损伤严重程度较低以及患者死亡率较低。这些差异可能相互关联，昆士兰州的规模和创伤护理组织欠佳可能起到了重要作用。
