Hong Zhi-Jie, Chen Cheng-Jueng, Chan De-Chuan, Chen Teng-Wei, Yu Jyh-Cherng, Hsu Sheng-Der
Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Division of Trauma Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Surg Today. 2019 Mar;49(3):261-267. doi: 10.1007/s00595-018-1723-y. Epub 2018 Oct 9.
The trauma team leader is a professional who receives and treats trauma patients. We aimed to evaluate whether or not the seniority of a qualified trauma team leader was a prognostic factor for multiple-trauma patients managed by a trauma team. This was a retrospective cohort study conducted at a Level I Trauma Center in North Taiwan. From January 2009 to December 2013, 284 patients were randomly assigned to one of two trauma team leaders (junior and senior leaders) on duty, irrespective of the seniority of the qualified trauma team leader. All parameters were collected and compared between these two groups. In the subgroup of multiple-trauma patients with Glasgow Coma Scale (GCS) ≤ 8, there were significant differences in the injury severity score, revised trauma score, and seniority of the leader between the alive and dead groups. A multivariate logistic regression analysis showed that the seniority of the trauma team leader was an important mortality risk factor [odds ratio (OR): 14.529, 95% confidence interval (CI) 1.683-125.429, p = 0.015] in patients with GCS ≤ 8. However, in patients with GCS > 8, age was the only independent risk factor [OR: 1.055, 95% CI 1.023-1.087, p = 0.001]. The seniority of the qualified trauma leader is important for teamwork, organization, and efficiency, all of which play an important role in improving the survival outcome of patients with GCS ≤ 8.
创伤团队负责人是接收和治疗创伤患者的专业人员。我们旨在评估合格的创伤团队负责人的资历是否是创伤团队管理的多发伤患者的预后因素。这是一项在台湾北部一级创伤中心进行的回顾性队列研究。2009年1月至2013年12月，284名患者被随机分配给两名值班的创伤团队负责人（初级和高级负责人）中的一位，而不考虑合格创伤团队负责人的资历。收集并比较了这两组之间的所有参数。在格拉斯哥昏迷量表（GCS）≤8的多发伤患者亚组中，存活组和死亡组在损伤严重程度评分、修订创伤评分和负责人资历方面存在显著差异。多因素逻辑回归分析显示，创伤团队负责人的资历是GCS≤8患者的重要死亡风险因素[比值比（OR）：14.529，95%置信区间（CI）1.683 - 125.429，p = 0.015]。然而，在GCS>8的患者中，年龄是唯一的独立风险因素[OR：1.055，95%CI 1.023 - 1.087，p = 0.001]。合格创伤负责人的资历对团队合作、组织和效率很重要，所有这些在改善GCS≤8患者的生存结局中都起着重要作用。
