Wang Tsung-Hsi, Jhao Wei-Siang, Yeh Yu-Hua, Pu Christy
Department of Medical Affairs, Ministry of Health and Welfare, Taiwan; Department of Public Health, School of Medicine, National Yang-Ming University, Taiwan.
Department of Medical Affairs, Ministry of Health and Welfare, Taiwan.
Burns. 2017 May;43(3):624-631. doi: 10.1016/j.burns.2016.10.008. Epub 2016 Dec 28.
To describe the experience of distributing 499 burn casualties of an unexpected event and determine whether patient transfer is associated with patient outcomes measured 2 weeks after the incident.
All 499 patients injured in the event were included. For the 138 patients transferred to other hospitals after primary distribution, we evaluated whether the transfers were associated with patient severity. Furthermore, we used multinomial logistic regression to investigate the association of patient transfer with patient outcomes after controlling for age, gender, total burn surface area (TBSA), final hospital level, wound infection, and patient pneumonia.
We determined that on-site triage differed significantly from hospital triage (p<0.001). Furthermore, the secondary distribution enabled the transfer of a high number of patients to medical centers based on the availability of beds; however, such transfers were not associated with patient outcomes (p>0.05). Factors associated with patient outcomes were wound infection and TBSA (p<0.001).
In case of inadequate burn centers, satisfactory patient outcomes can be achieved by the immediate treatment of patients, despite the treating hospitals being lower-level hospitals. Regardless of the hospital level, immediate treatment of burn patients is crucial to reducing mortality.
描述499例意外事件烧伤伤员的分配情况,并确定患者转运是否与事件发生2周后所测量的患者结局相关。
纳入该事件中受伤的所有499例患者。对于初次分配后转至其他医院的138例患者,我们评估了转运是否与患者严重程度相关。此外,我们使用多项逻辑回归分析,在控制年龄、性别、烧伤总面积(TBSA)、最终就诊医院级别、伤口感染和患者肺炎的情况下,研究患者转运与患者结局之间的关联。
我们确定现场分诊与医院分诊存在显著差异(p<0.001)。此外,二次分配使得大量患者能够根据床位情况转至医疗中心;然而,此类转运与患者结局无关(p>0.05)。与患者结局相关的因素是伤口感染和烧伤总面积(p<0.001)。
在烧伤中心不足的情况下,尽管救治医院级别较低,但通过对患者进行及时治疗仍可取得令人满意的患者结局。无论医院级别如何,对烧伤患者进行及时治疗对于降低死亡率至关重要。