Department of Paediatric Surgery, St George's Hospital, London, UK.
Emerg Med J. 2013 Oct;30(10):828-30. doi: 10.1136/emermed-2012-201125. Epub 2012 Oct 17.
The London Trauma Network was launched in April 2010 in order to centralise trauma care in the capital city. The consultation and resourcing of the four new major trauma centres (MTC) was adult focused. The objective of this study was to assess the impact that adult MTC status has on paediatric trauma workload.
A retrospective review of paediatric major trauma calls was performed between 1 April 2009 to 31 January 2010, before MTC status, and the same time period in 2010/11 when St George's Healthcare Trust was a designated adult MTC. The following variables were assessed; number of trauma calls, admissions to hospital, radiological services usage, inpatient stay, mechanism of injury and injury severity score (ISS)--calculated from abbreviated injury score.
There was a 200% increase in trauma calls between the two time periods and a 191% increase in admission to hospital. The usage of radiology increased 221% for CT and 161% for plain radiology. Mean inpatient stay decreased by 0.2 days. Mechanisms of injury were similar. Despite becoming a MTC the relative volume of major injuries (ISS>15) decreased between the two time periods by 1% with a relative increase in minor trauma (ISS<5) from 63% to 72%. These results may suggest at present paediatric trauma patients are being over triaged.
Major adult trauma centre status has a significant effect on paediatric trauma workload and hence resources. When reconfiguration of trauma services are being considered it is essential to take into account the impact on paediatric services alongside those of the adult population.
伦敦创伤网络于 2010 年 4 月成立，旨在将首都的创伤护理集中化。四个新的主要创伤中心（MTC）的咨询和资源配置以成人为主。本研究的目的是评估成人 MTC 地位对儿科创伤工作量的影响。
对 2009 年 4 月 1 日至 2010 年 1 月 31 日（MTC 地位之前）和 2010/11 年同期（当时圣乔治医疗信托基金是指定的成人 MTC）之间的儿科重大创伤呼叫进行回顾性审查。评估了以下变量：创伤呼叫次数、住院人数、放射服务使用情况、住院时间、损伤机制和损伤严重程度评分（ISS）-根据简明损伤评分计算。
两个时间段之间创伤呼叫增加了 200%，住院人数增加了 191%。放射学的使用量增加了 221%用于 CT，增加了 161%用于普通放射学。平均住院时间减少了 0.2 天。损伤机制相似。尽管成为 MTC，但两个时间段之间主要损伤（ISS>15）的相对数量减少了 1%，而轻微创伤（ISS<5）的相对数量从 63%增加到 72%。这些结果表明，目前儿科创伤患者可能存在过度分诊的情况。
主要成人创伤中心地位对儿科创伤工作量和资源有重大影响。在考虑重新配置创伤服务时，必须考虑到对儿科服务的影响，以及对成人人群的影响。
