直接送往创伤中心是否对严重创伤性脑损伤患者最佳？台湾中南部的一项研究。

Is direct transport to a trauma centre best for patients with severe traumatic brain injury? A study in south-central Taiwan.

机构信息

Department of Emergency Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.

出版信息

Emerg Med J. 2012 Feb;29(2):156-9. doi: 10.1136/emj.2010.097295. Epub 2010 Nov 2.

DOI:10.1136/emj.2010.097295

PMID:21045218

Abstract

OBJECTIVE

This study attempted to identify any differences between the outcomes of patients with severe traumatic brain injury (TBI) who were directly transported to Chang Gung Memorial Hospital and those who were stabilised initially at other hospitals in south-central Taiwan.

METHODS

A retrospective review of the records of 254 patients with isolated severe TBI who visited this hospital's emergency department from July 2003 to June 2008, of whom 167 were referred from other hospitals. Logistic regression was used to assess the effects of transfer and its components on mortality.

RESULTS

Transfer from another hospital was not significantly correlated with mortality in this study (OR 0.513, 95% CI 0.240 to 1.097). Moreover, neither intubation (OR 1.356, 95% CI 0.445 to 4.133) nor transfer time over 4 h (OR 0.549, 95% CI 0.119 to 1.744) had a significant effect on mortality.

CONCLUSION

No differences in outcome were found between patients with isolated severe TBI who were directly transported and those transferred to this hospital's emergency room.

摘要

目的

本研究旨在探讨直接转送至长庚纪念医院和先在台湾中南部其他医院稳定病情后转送至该院的严重创伤性脑损伤（TBI）患者的结局是否存在差异。

方法

回顾性分析 2003 年 7 月至 2008 年 6 月期间本院急诊科收治的 254 例单纯性严重 TBI 患者的病历，其中 167 例来自其他医院。采用 logistic 回归评估转院及其各组成部分对死亡率的影响。

结果

在本研究中，从其他医院转院与死亡率之间无显著相关性（OR 0.513，95% CI 0.240 至 1.097）。此外，气管插管（OR 1.356，95% CI 0.445 至 4.133）或转院时间超过 4 小时（OR 0.549，95% CI 0.119 至 1.744）均与死亡率无显著相关性。