Stanford University School of Medicine, Stanford, California 94305-5641, USA.
J Trauma Acute Care Surg. 2012 Mar;72(3):594-9; discussion 599-600. doi: 10.1097/TA.0b013e31824764ef.
Injured patients who are not transported by an ambulance to the hospital are often not included in trauma registries. The outcomes of these patients have until now been unknown. Understanding what happens to nontransports is necessary to better understand triage validity, patient outcomes, and costs associated with injury. We hypothesized that a subset of patients who were not transported from the scene would later present for evaluation and that these patients would have a nonzero mortality rate.
This is a population-based, retrospective cohort study of injured adults and children for three counties in California from 2006 to 2008. Prehospital data for injured patients for whom an ambulance was dispatched were probabilistically linked to trauma registry data from four trauma centers, state-level discharge data, emergency department records, and death files (1-year mortality).
A total of 69,413 injured persons who were evaluated at the scene by emergency medical services were included in the analysis. Of them, 5,865 (8.5%) were not transported. Of those not transported, 1,616 (28%) were later seen in an emergency department and discharged and 92 (2%) were admitted. Seven (0.2%) patients later died.
Patients evaluated by emergency medical services, but not initially transported from the field after injury, often present later to the hospital. The mortality rate in this population was not zero, and these patients may represent preventable deaths.
III, therapeutic study.
未通过救护车送往医院的受伤患者通常不会被纳入创伤登记处。这些患者的结局在此之前一直不为人知。了解未转运患者的情况对于更好地理解分诊的有效性、患者结局以及与损伤相关的成本是必要的。我们假设，一部分未从现场转运的患者会在之后到医院接受评估，且这些患者的死亡率不会为零。
这是一项基于人群的回顾性队列研究，研究对象为加利福尼亚州三个县的成年和儿童受伤患者，研究时间为 2006 年至 2008 年。对派出救护车的受伤患者的院前数据进行了概率性链接，以获取来自四个创伤中心、州级出院数据、急诊记录和死亡档案（1 年死亡率）的创伤登记处数据。
共有 69413 名在现场接受急救服务评估的受伤人员纳入分析。其中 5865 人（8.5%）未被转运。在未被转运的患者中，有 1616 人（28%）后来在急诊室就诊并出院，92 人（2%）被收治入院。有 7 人（0.2%）后来死亡。
由急救医疗服务机构评估但受伤后未立即从现场转运的患者通常会在之后到医院就诊。该人群的死亡率并非为零，这些患者可能代表可预防的死亡。
III 级，治疗性研究。
