Department of Surgery, Division of Emergency Medicine, University of Utah School of Medicine, Salt Lake City, UT 84132, USA.
Am J Emerg Med. 2012 Oct;30(8):1402-6. doi: 10.1016/j.ajem.2011.10.012. Epub 2011 Dec 26.
The University of Utah emergency department (ED) observation unit (EDOU) cares for over 2500 patients each year, with a significant portion of these patients being trauma activation patients. We evaluated the safety and efficacy of our EDOU trauma protocol and described patient characteristics and outcomes of trauma patients managed in an EDOU.
We performed a prospective observational study of all trauma patients admitted to the EDOU over a 1-year period. Patient disposition, interventions, and adverse events during observation were recorded. Thirty-day follow-up was performed by telephone and chart review to evaluate for missed injuries, repeat hospitalizations, or repeat traumatic events.
A total of 259 trauma patients were admitted to the EDOU during the study period and were contacted at least 30 days after discharge. There were no deaths, intubations, or other adverse events. At 30-day follow-up, there was 1 missed injury, which did not result in an adverse outcome. Ten patients were reevaluated in the ED or required hospitalization for events occurring after their initial EDOU stay but related to their initial trauma evaluation. The inpatient admission rate from the EDOU was 10.4%, and 3.1% of patients reported another traumatic event during the 30-day follow-up period.
There were no adverse outcomes in trauma patients admitted to the EDOU, and our inpatient admission rate was within the generally accepted admission rate for patients in observation status. The EDOU appears to be a safe alternative to inpatient admission for the evaluation of minimally injured trauma activation patients.
犹他大学急诊部（ED）观察单元（EDOU）每年收治超过 2500 名患者，其中相当一部分是创伤激活患者。我们评估了我们的 EDOU 创伤方案的安全性和有效性，并描述了在 EDOU 中接受治疗的创伤患者的特征和结局。
我们对在一年期间入住 EDOU 的所有创伤患者进行了前瞻性观察研究。记录了患者在观察期间的转归、干预措施和不良事件。通过电话和病历回顾进行 30 天随访，以评估是否有漏诊的损伤、再次住院或再次发生创伤性事件。
在研究期间，共有 259 名创伤患者入住 EDOU，并在出院后至少 30 天进行了联系。没有死亡、插管或其他不良事件。在 30 天随访时，有 1 例漏诊，但未导致不良后果。有 10 名患者因在 EDOU 初始住院后发生的与初始创伤评估相关的事件而在 ED 重新评估或需要住院治疗。EDOU 的住院入院率为 10.4%，3.1%的患者在 30 天随访期间报告了另一次创伤事件。
入住 EDOU 的创伤患者没有不良结局，我们的住院入院率在观察状态下患者的一般可接受入院率范围内。EDOU 似乎是评估轻度创伤激活患者的安全替代方案。
