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韩国由配备医生的直升机紧急医疗服务调度对成年钝性创伤患者的死亡率降低情况。

Reduced Mortality by Physician-Staffed HEMS Dispatch for Adult Blunt Trauma Patients in Korea.

作者信息

Jung Kyoungwon, Huh Yo, Lee John Cj, Kim Younghwan, Moon Jonghwan, Youn Seok Hwa, Kim Jiyoung, Kim Tea Youn, Kim Juryang, Kim Hyoju

机构信息

Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Korea.

Ajou Trauma Center (South Gyeonggi Regional Trauma Center), Ajou University Hospital, Suwon, Korea.

出版信息

J Korean Med Sci. 2016 Oct;31(10):1656-61. doi: 10.3346/jkms.2016.31.10.1656.

Abstract

The aim of this study was to investigate the efficiency of domestic physician-staffed helicopter emergency medical service (HEMS) for the transport of patients with severe trauma to a hospital. The study included patients with blunt trauma who were transported to our hospital by physician-staffed HEMS (Group P; n = 100) or nonphysician-staffed HEMS (Group NP; n = 80). Basic patient characteristics, transport time, treatment procedures, and medical treatment outcomes assessed using the Trauma and Injury Severity Score (TRISS) were compared between groups. We also assessed patients who were transported to the hospital within 3 h of injury in Groups P (Group P3; n = 50) and NP (Group NP3; n = 74). The severity of injury was higher, transport time was longer, and time from hospital arrival to operation room transfer was shorter for Group P than for Group NP (P < 0.001). Although Group P patients exhibited better medical treatment outcomes compared with Group NP, the difference was not statistically significant (P = 0.134 vs. 0.730). However, the difference in outcomes was statistically significant between Groups P3 and NP3 (P = 0.035 vs. 0.546). Under the current domestic trauma patient transport system in South Korea, physician-staffed HEMS are expected to increase the survival of patients with severe trauma. In particular, better treatment outcomes are expected if dedicated trauma resuscitation teams actively intervene in the medical treatment process from the transport stage and if patients are transported to a hospital to receive definitive care within 3 hours of injury.

摘要

本研究的目的是调查由国内医生配备的直升机紧急医疗服务(HEMS)将严重创伤患者转运至医院的效率。该研究纳入了钝性创伤患者,这些患者由医生配备的HEMS转运至我院(P组;n = 100)或非医生配备的HEMS转运至我院(NP组;n = 80)。比较了两组患者的基本特征、转运时间、治疗程序以及使用创伤和损伤严重程度评分(TRISS)评估的医疗治疗结果。我们还评估了在受伤后3小时内被转运至医院的P组患者(P3组;n = 50)和NP组患者(NP3组;n = 74)。与NP组相比,P组的损伤严重程度更高,转运时间更长,从医院到达至手术室转移的时间更短(P < 0.001)。尽管P组患者与NP组相比表现出更好的医疗治疗结果,但差异无统计学意义(P = 0.134对0.730)。然而,P3组和NP3组之间的结果差异具有统计学意义(P = 0.035对0.546)。在韩国当前的国内创伤患者转运系统下,由医生配备的HEMS有望提高严重创伤患者的生存率。特别是,如果专门的创伤复苏团队在转运阶段就积极介入医疗治疗过程,并且患者在受伤后3小时内被转运至医院接受确定性治疗,预计会有更好的治疗结果。

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