Galvagno Samuel M, Dubose Joseph J, Grissom Thomas E, Fang Raymond, Smith Richard, Bebarta Vikhyat S, Shackelford Stacy, Scalea Thomas M
Divisions of Trauma Anesthesiology and Critical Care Medicine, Department of Anesthesiology, Program in Trauma, Shock Trauma Center, University of Maryland School of Medicine, T1R83, 22 South Greene Street, Baltimore, MD 21201.
Program in Trauma, Shock Trauma Center, University of Maryland School of Medicine, 22 South Greene Street, Baltimore, MD 21201.
Mil Med. 2014 Jun;179(6):612-8. doi: 10.7205/MILMED-D-13-00474.
Critical Care Air Transport Teams (CCATTs) have evolved as a vital component of the U.S. Air Force's aeromedical evacuation system. Previous epidemiological research in this area is limited. The objective of this commentary is to highlight the importance of obtaining robust epidemiological data regarding patients transported by CCATTs. A limited epidemiological analysis was performed to describe CCATT patients transported during Operation Enduring Freedom and the waning months of Operation Iraqi Freedom. CCATT transports for the calendar year 2011 were examined as recorded in the U.S. Transportation Command Regulating and Command and Control (C2) Evacuation System database. As many as 290 CCATT primary patient transport records were reviewed. Of these, 58.6% of patients had multiple injuries, 15.9% of patients had traumatic brain injury, 7% had acute coronary syndromes, and 24.8% of all transports were for nonbattle-related injuries. The most common International Classification of Disease, 9th Edition, Clinical Modification coded injury was bilateral lower extremity amputation (40%). Explosive blasts were the top mechanism of injury for patients requiring CCAT. The distribution of injuries and illnesses requiring CCAT appear to have changed compared to previous conventional conflicts. Understanding the epidemiology of casualties evacuated by CCATT during modern warfare is a prerequisite for the development of effective predeployment training to ensure optimal outcomes for critically ill and injured warriors.
重症监护空运团队（CCATTs）已发展成为美国空军航空医疗后送系统的重要组成部分。此前该领域的流行病学研究有限。本评论的目的是强调获取关于由CCATTs转运患者的可靠流行病学数据的重要性。进行了有限的流行病学分析，以描述在持久自由行动和伊拉克自由行动后期数月由CCATTs转运的患者情况。对2011年全年CCATTs的转运情况进行了检查，数据记录在美国运输司令部调控与指挥控制（C2）后送系统数据库中。共审查了多达290份CCATTs主要患者转运记录。其中，58.6%的患者有多处损伤，15.9%的患者有创伤性脑损伤，7%有急性冠状动脉综合征，所有转运中有24.8%是针对与战斗无关的损伤。最常见的国际疾病分类第九版临床修订本编码损伤是双侧下肢截肢（40%）。爆炸是需要CCAT的患者的首要致伤机制。与以往的传统冲突相比，需要CCAT的损伤和疾病分布似乎有所变化。了解现代战争期间由CCATTs后送的伤亡人员的流行病学情况，是开展有效的部署前培训以确保重症伤病员获得最佳治疗效果的前提条件。
