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意大利双子枢纽医院在双重地震事件中的应对:一项回顾性观察研究。

Response by Twin Italian Hub Hospitals in a Double Seismic Event: A Retrospective Observational Investigation.

作者信息

Barbieri Alberto, Melegari Gabriele, Lob Valentina, Mazzali Lorenzo, D'Amelio Luca, Giovannoni Andrea, Giuliani Enrico

出版信息

Prehosp Emerg Care. 2018 May-Jun;22(3):353-360. doi: 10.1080/10903127.2017.1394406. Epub 2018 Jan 18.

Abstract

INTRODUCTION

The objectives of this study were to compare prevalence rates of different pathologies, ambulance system and emergency department management times, and patient survival and hazard ratios for codes 2 and 3 in two hub hospitals in Modena in the 36-month period across the stages of two major earthquakes in short sequence in Northern Italy in 2012.

METHODS

Clinical records pertaining to the emergency care of patients were analyzed and only those assigned status codes 2 and 3 by ambulance professionals were included (if the assessment was confirmed by emergency department triage). The statistical analysis of data was divided by three time periods studied: before, during/between, and after the earthquakes.

RESULTS

Among the 2,278 retained records, there were no statistically significant differences in the prevalence of the main pathologies presented at the two hubs in the studied period. A Cox regression model was used to analyze the survival of patients in the different stages of the emergency; there were no statistically significant differences in the hazard ratios of death before, during, and after the earthquake. The study found a significant increase in emergency department treatment times.

DISCUSSION

Redundancies in the Modena medical system were found to have compensated for damaged hospital facilities. In particular, they helped emergency systems reorganize themselves faster in order to bring medical assistance to people during and around seismic events with as a minimal amount of disruption as possible.

CONCLUSION

The Modena medical system was redundant and ensured that disrupted emergency systems were reorganized and put back online while damaged hospital facilities were compensated for/reproduced elsewhere.

摘要

引言

本研究的目的是比较2012年意大利北部短时间内相继发生的两次大地震不同阶段中,摩德纳两家中心医院在36个月期间不同病理的患病率、救护车系统和急诊科的处理时间,以及2级和3级病例的患者生存率和风险比。

方法

分析了与患者急诊护理相关的临床记录,仅纳入了经救护车专业人员评定为2级和3级的病例(前提是该评估得到急诊科分诊的确认)。数据的统计分析按三个研究时间段划分:地震前、地震期间/两次地震之间、地震后。

结果

在保留的2278份记录中,研究期间两家中心医院主要病理的患病率无统计学显著差异。采用Cox回归模型分析患者在急诊不同阶段的生存情况;地震前、地震期间和地震后的死亡风险比无统计学显著差异。研究发现急诊科的治疗时间显著增加。

讨论

发现摩德纳医疗系统的冗余弥补了受损的医院设施。特别是,它们帮助应急系统更快地进行自我重组,以便在地震期间及地震前后以尽可能小的干扰为人们提供医疗援助。

结论

摩德纳医疗系统具备冗余性,确保了受干扰的应急系统得以重组并恢复运行,同时受损的医院设施在其他地方得到了弥补/重建。

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