Bundi M, Meier L, Amsler F, Gross T
Abteilung Traumatologie, Klinik für Chirurgie, Kantonsspital Aarau, Tellstrasse, 5001, Aarau, Schweiz.
Unfallchirurg. 2018 Jan;121(1):10-19. doi: 10.1007/s00113-016-0267-0.
The potential association of external factors such as time of day, lunar phases or specific weather conditions on the daily management and outcome of trauma emergencies remains under debate. We undertook this trauma centre investigation to detect possible worthwhile factors of influence in order to optimize the organizational structure of trauma admissions.
Retrospective cohort analysis over the years 2010-2013, including all emergency trauma admissions with a new injury severity score (NISS) ≥8 (major trauma) treated in a teaching hospital in the lowland of Switzerland (uni- and multivariable analysis; p < 0.05).
During the study period, 1178 major trauma patients were admitted to the hospital. The mean age of trauma victims was 53 ± 23 and the average ISS was 14 ± 8. More patients arrived within the summer months than during the rest of the year (p < 0.001). Higher energy trauma was found to correlate with higher daytime temperature, longer duration of sunshine (each p < 0.001), and change in weather conditions (p = 0.008). In contrast, snowfall and lunar phases did not demonstrate any association with the number or characteristics of trauma admissions. Multivariable analysis demonstrated that altogether longer sunshine, higher minimum daytime temperature and lower air humidity, compared to the previous day, accounted for 31 % of major trauma admissions. We could not find any impact of the investigated external factors on the outcome of patients.
The study shows a significant relationship between specific weather conditions, such as higher daytime temperature or change in circulation, and the admission of major trauma patients. Due to the small effect in our setting, our results do not implicate any according change in the management of resources. Nevertheless, for hospitals in other geographic or more exposed weather regions, such effects could indeed be relevant and therefore should be tested.
诸如一天中的时间、月相或特定天气状况等外部因素与创伤急诊的日常管理及预后之间的潜在关联仍存在争议。我们开展了这项创伤中心调查,以探寻可能有价值的影响因素,从而优化创伤入院的组织结构。
对2010年至2013年进行回顾性队列分析,纳入瑞士低地一家教学医院收治的所有新损伤严重程度评分(NISS)≥8(严重创伤)的急诊创伤患者(单变量和多变量分析;p<0.05)。
在研究期间,1178例严重创伤患者入院。创伤受害者的平均年龄为53±23岁,平均损伤严重度评分(ISS)为14±8。夏季入院的患者比一年中的其他时间更多(p<0.001)。发现更高能量的创伤与更高的日间温度、更长的日照时长(均p<0.001)以及天气状况变化(p=0.008)相关。相比之下,降雪和月相与创伤入院的数量或特征无任何关联。多变量分析表明,与前一天相比,总体上更长的日照时长、更高的日间最低温度和更低的空气湿度可解释31%的严重创伤入院情况。我们未发现所调查的外部因素对患者预后有任何影响。
该研究表明特定天气状况,如更高的日间温度或环流变化,与严重创伤患者入院之间存在显著关联。由于在我们的研究环境中影响较小,我们的结果并不意味着资源管理需要相应改变。然而,对于其他地理区域或天气状况更易受影响地区的医院,此类影响可能确实相关,因此应进行测试。