Zhang Gui Xi, Fan Joe King Man, Chan Fion Siu Yin, Leung Gilberto Ka Kit, Lo Chung Mao, Yu Yi Min, Zhang Hong, Brundage Susan I, Jansen Jan O
Department of Surgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.
World J Surg. 2017 Sep;41(9):2207-2214. doi: 10.1007/s00268-017-4002-y.
The city of Shenzhen, China, is planning to establish a trauma system. At present, there are few data on the geographical distribution of incidents, which is key to deciding on the location of trauma centres. The aim of this study was to perform a geographical analysis in order to inform the development of a trauma system in Shenzhen.
Retrospective analysis of trauma incidents attended by Shenzhen Emergency Medical Services (EMS) in 2014. Data were obtained from Shenzhen EMS. Incident distribution was explored using dot and kernel density estimate maps. Clustering was determined using the nearest neighbour index. The type of healthcare facilities which patients were taken to was compared against patients' needs, as assessed using the Field Triage Decision Scheme.
There were 49,082 recorded incidents. A total of 3513 were classed as major trauma. Mapping demonstrates that incidents predominantly occurred in the western part of Shenzhen, with identifiable clusters. Nearest neighbour index was 0.048. Of patients deemed to have suffered major trauma, 8.5% were taken to a teaching hospital, 13.6% to a regional hospital, 42.6% to a community hospital, and 35.3% to a private hospital. The proportions of Step 1 or 2 negative patients were almost identical.
The majority of trauma patients, including trauma patients who are at greater likelihood of severe injury, are taken to regional and community hospitals. There are areas with identifiable concentrations of volume, which should be considered for the siting of high-level trauma centres, although further modelling is required to make firm recommendations.
中国深圳市正计划建立一个创伤系统。目前，关于创伤事件地理分布的数据很少，而这对于确定创伤中心的位置至关重要。本研究的目的是进行地理分析，为深圳创伤系统的发展提供依据。
对2014年深圳市紧急医疗服务（EMS）处理的创伤事件进行回顾性分析。数据来自深圳EMS。使用点状图和核密度估计图探索事件分布。使用最近邻指数确定聚类情况。将患者被送往的医疗设施类型与使用现场分诊决策方案评估的患者需求进行比较。
共记录了49082起事件。其中3513起被归类为重大创伤。地图显示事件主要发生在深圳西部，有明显的聚类。最近邻指数为0.048。在被认为遭受重大创伤的患者中，8.5%被送往教学医院，13.6%被送往区域医院，42.6%被送往社区医院，35.3%被送往私立医院。第1步或第2步阴性患者的比例几乎相同。
大多数创伤患者，包括重伤可能性较大的创伤患者，被送往区域医院和社区医院。存在创伤事件集中的区域，选址高水平创伤中心时应予以考虑，不过还需要进一步建模才能给出确切建议。
