Sierink Joanne C, de Jong Evin Wm, Schep Niels Wl, Goslings J Carel
Trauma Unit, Department of Surgery, Academic Medical Center, Meibergdreef 9, Amsterdam 1105, AZ, the Netherlands.
J Trauma Manag Outcomes. 2014 Aug 6;8:11. doi: 10.1186/1752-2897-8-11. eCollection 2014.
Since time intervals are used to determine quality of trauma care, it is relevant to know how reliable those intervals can be measured. The aim of our study was to assess the reliability of time intervals as recorded in our hospital databases.
We conducted a prospective study on time intervals in our level-1 trauma centre and compared those with the routinely recorded data from February 2012 to June 2012. A convenience sample of all trauma patients admitted to our trauma room was included. The routinely recorded time intervals were retrieved from computerised hospital databases. The dedicated time registration was done on a standardised form on which five time intervals considered clinically relevant were evaluated for each patient by a dedicated person: trauma room time, time to start CT, imaging time, time from trauma room to ICU and time from trauma room to intervention.
In a sample of 100 trauma patients dedicated registered trauma room time was median 47 minutes (IQR = 32-63), compared to 42 minutes (IQR = 28-56) in routinely recorded in hospital databases (P < 0.001). Time to start of CT scanning differed significantly as well, with again an increased time interval measured dedicatedly (median 20 minutes (IQR = 15-28)) compared to the routinely recorded time registration (median 13 minutes (IQR = 4-21)). The other time intervals recorded did not differ between the dedicated and routinely recorded registration. Bland-Altman plots also showed that there is considerable discrepancy between the two measurement methods with wide limits of agreement.
This study shows that routinely recorded time intervals in the trauma care setting differ statistically significant from dedicatedly registered intervals.
由于时间间隔用于确定创伤护理的质量,因此了解这些间隔的测量可靠性至关重要。我们研究的目的是评估我院数据库中记录的时间间隔的可靠性。
我们在一级创伤中心对时间间隔进行了前瞻性研究,并将其与2012年2月至2012年6月的常规记录数据进行了比较。纳入了所有入住我院创伤室的创伤患者的便利样本。常规记录的时间间隔从计算机化的医院数据库中检索。专门的时间登记采用标准化表格进行,由专人对每位患者评估五个被认为具有临床相关性的时间间隔:创伤室时间、开始CT检查的时间、成像时间、从创伤室到重症监护病房的时间以及从创伤室到干预的时间。
在100例创伤患者的样本中,专门登记的创伤室时间中位数为47分钟(四分位间距=32 - 63),而医院数据库中的常规记录时间为42分钟(四分位间距=28 - 56)(P < 0.001)。开始CT扫描的时间也有显著差异,专门测量的时间间隔再次增加(中位数20分钟(四分位间距=15 - 28)),而常规记录的时间登记为中位数13分钟(四分位间距=4 - 21)。其他记录的时间间隔在专门登记和常规记录之间没有差异。布兰德 - 奥特曼图还显示,两种测量方法之间存在相当大的差异,一致性界限较宽。
本研究表明,创伤护理环境中常规记录的时间间隔与专门登记的间隔在统计学上有显著差异。