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基于紧急医疗服务运输方式的医院死亡率

Hospital Mortality Based on the Mode of Emergency Medical Services Transportation.

作者信息

Al-Thani Hassan, El-Menyar Ayman, Pillay Yugan, Mollazehi Monira, Mekkodathil Ahammed, Consunji Rafael

机构信息

Trauma Surgery Section, Department of Surgery, Hamad Medical Corporation, Doha, Qatar.

Clinical Research, Trauma Surgery Section, Hamad Medical Corporation, Doha, Qatar; Clinical Medicine, Weill Cornell Medical College, Doha, Qatar.

出版信息

Air Med J. 2017 Jul-Aug;36(4):188-192. doi: 10.1016/j.amj.2017.03.003. Epub 2017 Apr 20.

Abstract

OBJECTIVE

We assessed the presentations and outcomes of trauma patients transported by helicopter emergency medical services (HEMS) versus ground emergency medical services (GEMS).

METHODS

A retrospective analysis of trauma registry data at a level I trauma center was conducted for patients transported by GEMS and HEMS between 2011 and 2013. Data were analyzed and categorized based on the mode of transportation.

RESULTS

A total of 4,596 trauma patients were admitted to the hospital with a mean age of 31 ± 15 years. Injured patients were transported to the trauma center by GEMS (93.3%) and HEMS (6.7%). The common mechanisms of injury were motor vehicle crash (37%) and falls (25%). Compared with GEMS, patients transported by HEMS were characterized by having a greater injury severity, more proportion of traumatic brain injury, on-scene intubation, and a 2.5-fold higher mortality. However, the impact of mode of transportation on the hospital mortality among severely injured patients has disappeared after adjusting for potential confounders.

CONCLUSION

Patients transported by HEMS may have different characteristic features and outcomes when compared with GEMS. However, further work is needed to identify the subgroups of trauma patients who clearly benefit from the use of HEMS.

摘要

目的

我们评估了由直升机紧急医疗服务(HEMS)与地面紧急医疗服务(GEMS)转运的创伤患者的临床表现和结局。

方法

对2011年至2013年间由GEMS和HEMS转运至一级创伤中心的创伤登记数据进行回顾性分析。根据运输方式对数据进行分析和分类。

结果

共有4596例创伤患者入院,平均年龄为31±15岁。受伤患者由GEMS(93.3%)和HEMS(6.7%)转运至创伤中心。常见的损伤机制是机动车碰撞(37%)和跌倒(25%)。与GEMS相比,由HEMS转运的患者具有损伤严重程度更高、创伤性脑损伤比例更高、现场插管以及死亡率高2.5倍的特点。然而,在调整潜在混杂因素后,运输方式对重伤患者医院死亡率的影响消失了。

结论

与GEMS相比,由HEMS转运的患者可能具有不同的特征和结局。然而,需要进一步开展工作以确定明显受益于使用HEMS的创伤患者亚组。

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