Alshahrani Mohammed S
Department of Emergency, King Fahad Hospital of the University, University of Dammam, Al Khobar, Kingdom of Saudi Arabia.
J Family Community Med. 2017 Jan-Apr;24(1):30-33. doi: 10.4103/2230-8229.197179.
To assess the effect of the mode of transportation of trauma patients (emergency medical service [EMS] vs. non-EMS) on their final clinical outcome in terms of mortality and length of hospital stay.
A retrospective study included all patients who were involved in motor vehicle crashes, and who were transferred immediately to an emergency department of a trauma care center from December 2008 to December 2012. Patients were classified into two groups: those brought through EMS and those brought by non-EMS (private transport). Information on demographic characteristics including age and gender was recorded and medical data such as blood pressure, pulse, oxygen saturation, temperature, initial Glasgow Coma Score (GCS), saturation, temperature, initial Glasgow Coma Score (GCS), injury severity score (ISS), and final outcome (discharged or expired) were obtained. Descriptive statistics, mean and standard deviation (SD) were computed for continuous variables and statistical significance was tested by -test or Mann-Whitney U-test. Categorical variables were described by frequency distribution and percentages; Chi-square or Fisher's exact test as appropriate were employed to test for statistical significance. Logistics regression was performed with mortality as dependent variable and mode of transport and all demographic and prehospital variables as independent variables. A general linear model analysis was performed to test whether the mode of transport was significant to length of hospital stay in EMS and non-EMS clients.
Out of 308 patients identified during the study period, 232 were transported through EMS and 76 through non-EMS. The two groups were similar with regard to mortality and length of stay. The crude mortality rate was 30.6% (95% confidence interval [CI]: 24.64-36.53) in the EMS group and 28.9% (95% CI: 18.44-38.76) in the non-EMS group ( = 0.785). The average length of hospital stay was 9 days (interquartile range [IQR] = 8, 95% CI: 7.3-10.1) for the EMS group and 8 days (IQR = 9.5, 95% CI: 6.7-10.9) for the non-EMS group ( = 0.803). Multivariate analysis showed that of the study variables, only the injury severity score (ISS) and Glasgow coma score (GCS) were significant to mortality ( < 0.01), and GCS was more significant to the length of hospital stay ( < 0.01).
There was no significant difference between the EMS and non-EMS groups as they relate to mortality and length of stay in hospital. However, the mortality and length of hospital stay was statistically significant to ISS and GCS.
评估创伤患者的转运方式（紧急医疗服务[EMS]与非EMS）对其最终临床结局（死亡率和住院时间）的影响。
一项回顾性研究纳入了所有在2008年12月至2012年12月期间发生机动车碰撞事故并立即被转运至创伤护理中心急诊科的患者。患者被分为两组：通过EMS转运的患者和通过非EMS（私人交通工具）转运的患者。记录了包括年龄和性别在内的人口统计学特征信息，并获取了诸如血压、脉搏、血氧饱和度、体温、初始格拉斯哥昏迷评分（GCS）、饱和度、体温、初始格拉斯哥昏迷评分（GCS）、损伤严重程度评分（ISS）以及最终结局（出院或死亡）等医疗数据。对连续变量计算描述性统计量、均值和标准差（SD），并通过t检验或曼-惠特尼U检验检验统计学显著性。分类变量通过频率分布和百分比进行描述；采用卡方检验或适当的费舍尔精确检验来检验统计学显著性。以死亡率为因变量，转运方式以及所有人口统计学和院前变量为自变量进行逻辑回归分析。进行一般线性模型分析以检验转运方式对EMS和非EMS患者住院时间是否具有显著性。
在研究期间确定的308例患者中，232例通过EMS转运，76例通过非EMS转运。两组在死亡率和住院时间方面相似。EMS组的粗死亡率为30.6%（95%置信区间[CI]：24.64 - 36.53），非EMS组为28.9%（95%CI：18.44 - 38.76）（P = 0.785）。EMS组的平均住院时间为9天（四分位间距[IQR] = 8，95%CI：7.3 - 10.1），非EMS组为8天（IQR = 9.5，95%CI：6.7 - 10.9）（P = 0.803）。多变量分析表明，在研究变量中，只有损伤严重程度评分（ISS）和格拉斯哥昏迷评分（GCS）对死亡率具有显著性（P < 0.01），而GCS对住院时间更具显著性（P < 0.01）。
EMS组和非EMS组在死亡率和住院时间方面无显著差异。然而，死亡率和住院时间对ISS和GCS具有统计学显著性。
