Al-Shaqsi Sultan, Al-Kashmiri Ammar, Al-Hajri Hamood, Al-Harthy Abdullah
Preventive and Social Medicine, University of Otago, Dunedin School of Medicine, Dunedin, New Zealand.
Emergency Department, Khoula Hospital, Ministry of Health, Muscat, Sultanate of Oman.
Emerg Med J. 2014 Sep;31(9):754-7. doi: 10.1136/emermed-2013-202779. Epub 2013 Jul 3.
This study aims to assess the differences in the outcome of road traffic trauma patients between those transported by emergency medical services (EMS) and those privately transported to the Sultan Qaboos University Hospital in the Sultanate of Oman in 2011.
This is a retrospective study of road traffic trauma patients admitted to the Sultan Qaboos University Hospital between January to December 2011. Data for all cases were retrieved from the emergency department database. The general linear multivariate regression analysis model was performed to test the differences in outcome. The analysis controlled for age, gender, ethnicity, weekend injury, time of injury, triage status, Injury Severity Score, existence of head injury, need for intensive care unit admission and need for surgical management.
There were 821 trauma cases in 2011. 66.7% were transported by EMS. Male patients represented 65.7% of the cases. There was no significant difference in the characteristics of EMS and non-EMS trauma patients. In terms of inhospital mortality, the relative ratio of inhospital mortality between EMS and non-EMS groups was 0.64 (0.36-1.13), and p value 0.13. There is no significant difference in all other secondary outcomes tested.
EMS transported trauma patients had a statistically non-significant 36% reduction in mortality compared with privately transported patients admitted to the Sultan Qaboos University Hospital in 2011. Further, research that incorporates prehospital factors such as crash to arrival of EMS services and transport time to definitive healthcare facility should be conducted to evaluate the effectiveness of such a system in trauma care. Since non-EMS transport is likely to continue, public first aid training is critical to reduce mortality and morbidity of road traffic trauma in Oman.
本研究旨在评估2011年在阿曼苏丹国,由紧急医疗服务(EMS)运送的道路交通创伤患者与自行前往苏丹卡布斯大学医院的患者在治疗结果上的差异。
这是一项对2011年1月至12月间收治于苏丹卡布斯大学医院的道路交通创伤患者的回顾性研究。所有病例的数据均从急诊科数据库中获取。采用一般线性多元回归分析模型来检验治疗结果的差异。该分析对年龄、性别、种族、周末受伤情况、受伤时间、分诊状态、损伤严重程度评分、是否存在头部损伤、是否需要入住重症监护病房以及是否需要手术治疗等因素进行了控制。
2011年共有821例创伤病例。其中66.7%由EMS运送。男性患者占病例总数的65.7%。EMS创伤患者和非EMS创伤患者的特征无显著差异。在住院死亡率方面,EMS组与非EMS组的住院死亡率相对比值为0.64(0.36 - 1.13),p值为0.13。在所有其他测试的次要结果中均无显著差异。
与2011年自行前往苏丹卡布斯大学医院的患者相比,由EMS运送的创伤患者死亡率在统计学上虽无显著差异,但降低了36%。此外,应开展纳入诸如EMS服务从事故发生到抵达的时间以及转运至最终医疗机构的时间等院前因素的研究,以评估该系统在创伤护理中的有效性。由于非EMS转运可能会继续存在,公众急救培训对于降低阿曼道路交通创伤的死亡率和发病率至关重要。