Schoeneberg C, Schilling M, Hussmann B, Schmitz D, Lendemans S, Ruchholtz S
Department of Emergency and Orthopedic Surgery, Alfried Krupp Hospital, Hellweg 100, 45276, Essen, Germany.
Clinic for Orthopedics, Pius-Hospital Oldenburg, Oldenburg, Germany.
Eur J Trauma Emerg Surg. 2017 Aug;43(4):481-489. doi: 10.1007/s00068-016-0670-9. Epub 2016 Apr 12.
Analyzing preventable and potentially preventable deaths is a well-known procedure for improving trauma care. This study analyzes preventable and potentially preventable deaths in German trauma patients.
Patients aged between 16 and 75 years with an Injury Severity Score >15 who were primary admitted from July 2002 to December 2011 were analyzed in this study. Data from the patients' hospital records were retrospectively analyzed, and cases were categorized as preventable, potentially preventable, and non-preventable deaths. In addition, trauma management was screened for errors.
2304 patients were admitted from July 2002 to December 2011. 763 of which fulfilled the defined criteria. The mortality rate was 25.3 %. Eight cases (4.2 %) were declared as preventable deaths and 31 cases (16.1 %) as potentially preventable deaths. The most common errors in preclinical trauma care related to airway management. The main clinical error was insufficient hemorrhage control. Fluid overload from infusion was the second most common fault in both.
Preventable and potentially preventable errors still occur in the treatment of severely injured patients. Errors in hemorrhage control and airway management are the most common human treatment errors. The knowledge of these errors could help to improve trauma care in the future.
分析可预防和潜在可预防的死亡是改善创伤护理的一项众所周知的程序。本研究分析德国创伤患者中可预防和潜在可预防的死亡情况。
本研究分析了2002年7月至2011年12月期间首次入院的年龄在16至75岁之间、损伤严重度评分>15的患者。对患者医院记录中的数据进行回顾性分析，并将病例分为可预防死亡、潜在可预防死亡和不可预防死亡。此外，筛查创伤管理中的错误。
2002年7月至2011年12月期间收治了2304例患者。其中763例符合既定标准。死亡率为25.3%。8例（4.2%）被判定为可预防死亡，31例（16.1%）为潜在可预防死亡。院前创伤护理中最常见的错误与气道管理有关。主要的临床错误是出血控制不足。输液导致的液体超负荷是两者中第二常见的失误。
在重伤患者的治疗中仍会出现可预防和潜在可预防的错误。出血控制和气道管理方面的错误是最常见的人为治疗错误。了解这些错误有助于未来改善创伤护理。
