印度和德国的创伤护理。
Trauma care in India and Germany.
机构信息
Department of Traumatology, Orthopaedics, and Neurotraumatology, AO Foundation, Schubertstraße 12, D-29223, Celle, Germany.
出版信息
Clin Orthop Relat Res. 2013 Sep;471(9):2869-77. doi: 10.1007/s11999-013-3035-2.
BACKGROUND
Road traffic accidents are among the leading causes of death worldwide in individuals younger than 45 years. In both India and Germany, there has been an increase in registered motor vehicles over the last decades. However, while the number of traffic accident victims steadily dropped in Germany, there has been a sustained increase in India. We analyze this considering the sustained differences in rescue and trauma system status.
QUESTIONS/PURPOSES: We compared India and Germany in terms of (1) vehicular infrastructure and causes of road traffic accident-related trauma, (2) burden of trauma, and (3) current trauma care and prevention, and (4) based on these observations, we suggested how India and other countries can enhance trauma care and prevention.
METHODS
Data for Germany were obtained from federal statistical databases, German Automobile Club, and German Trauma Registry. Data from India were available from the Ministry of Road Transport and Highways. We also performed a standardized literature search of PubMed for India and Germany using the following key words: "road traffic accidents", "prevention", "prehospital trauma care", "trauma system", "trauma registry", "trauma centers", and "development of vehicles."
RESULTS
The total number of registered motor vehicles increased 473-fold in India and 100-fold in Germany from 1951 to 2011. The number of road traffic deaths increased in both countries until 1970, but thereafter decreased in Germany (3606 in 2012) while continuing to increase in India (142,485 in 2011). The differences between Germany and India relate to the relative sizes and populations of the countries (1:9 and 1:15, respectively), and differences in prevention and prehospital care (nationwide versus big cities) and hospital trauma systems (nationwide versus exceptional).
CONCLUSIONS
Improvement requires attention to three major issues: (1) prevention through infrastructure, traffic laws, mandatory licensing; (2) establishment of a prehospital care system; and (3) establishment of regional trauma centers and a trauma registry.
背景
道路交通伤害是全球 45 岁以下人群的主要死亡原因之一。在印度和德国，过去几十年中注册的机动车辆数量都有所增加。然而，尽管德国的交通事故受害者人数稳步下降，但印度却持续增加。我们分析了这一点，并考虑到救援和创伤系统状况的持续差异。
问题/目的：我们比较了印度和德国在以下几个方面的情况：（1）车辆基础设施和道路交通伤害相关创伤的原因，（2）创伤负担，（3）当前的创伤救治和预防，（4）根据这些观察结果，我们提出了印度和其他国家如何加强创伤救治和预防的建议。
方法
德国的数据来自联邦统计数据库、德国汽车俱乐部和德国创伤登记处。印度的数据来自道路运输和公路部。我们还使用以下关键词在 PubMed 上对印度和德国进行了标准化文献检索：“道路交通伤害”、“预防”、“院前创伤救治”、“创伤系统”、“创伤登记处”、“创伤中心”和“车辆发展”。
结果
1951 年至 2011 年，印度注册的机动车辆总数增加了 473 倍，德国增加了 100 倍。这两个国家的道路交通死亡人数在这期间都有所增加，直到 1970 年，但此后德国（2012 年为 3606 人）的死亡人数下降，而印度（2011 年为 142485 人）的死亡人数继续增加。德国和印度之间的差异与两国的相对规模和人口有关（分别为 1:9 和 1:15），以及预防和院前护理（全国性与大城市）和医院创伤系统（全国性与例外）的差异。
结论
改善需要关注三个主要问题：（1）通过基础设施、交通法规、强制许可来进行预防；（2）建立院前救护系统；（3）建立区域创伤中心和创伤登记处。
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