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韩国创伤团队启动标准的验证

Validation of the Korean criteria for trauma team activation.

作者信息

Bang Minhyuk, Kim Yong Won, Kim Oh Hyun, Lee Kang Hyun, Jung Woo Jin, Cha Yong Sung, Kim Hyun, Hwang Sung Oh, Cha Kyoung-Chul

机构信息

Department of Emergency Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea.

出版信息

Clin Exp Emerg Med. 2018 Dec;5(4):256-263. doi: 10.15441/ceem.17.265. Epub 2018 Dec 31.

Abstract

OBJECTIVE

We conducted a study to validate the effectiveness of the Korean criteria for trauma team activation (TTA) and compared its results with a two-tiered system.

METHODS

This observational study was based on data from the Korean Trauma Data Bank. Within the study period, 1,628 trauma patients visited our emergency department, and 739 satisfied the criteria for TTA. The rates of overtriage and undertriage in the Korean one-tiered system were compared with the two-tiered system recommended by the American College of Surgery-Committee on Trauma.

RESULTS

Most of the patient's physiologic factors reflected trauma severity levels, but anatomical factors and mechanism of injury did not show consistent results. In addition, while the rate of overtriage (64.4%) was above the recommended range according to the Korean criteria, the rate of undertriage (4.0%) was within the recommended range. In the simulated two-tiered system, the rate of overtriage was reduced by 5.5%, while undertriage was increased by 1.8% compared to the Korean activation system.

CONCLUSION

The Korean criteria for TTA showed higher rates of overtriage and similar undertriage rates compared to the simulated two-tier system. Modification of the current criteria to a two-tier system with special considerations would be more effective for providing optimum patient care and medical resource utilization.

摘要

目的

我们开展了一项研究,以验证韩国创伤团队启动(TTA)标准的有效性,并将其结果与两级系统进行比较。

方法

这项观察性研究基于韩国创伤数据库的数据。在研究期间,1628名创伤患者就诊于我们的急诊科,其中739名符合TTA标准。将韩国单级系统中的过度分诊和漏分诊率与美国外科医师学会创伤委员会推荐的两级系统进行比较。

结果

大多数患者的生理因素反映了创伤严重程度,但解剖因素和损伤机制并未显示出一致的结果。此外,根据韩国标准,过度分诊率(64.4%)高于推荐范围,而漏分诊率(4.0%)在推荐范围内。在模拟的两级系统中,与韩国启动系统相比,过度分诊率降低了5.5%,而漏分诊率增加了1.8%。

结论

与模拟的两级系统相比,韩国TTA标准显示出更高的过度分诊率和相似的漏分诊率。将当前标准修改为具有特殊考虑因素的两级系统,对于提供最佳患者护理和医疗资源利用将更为有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c63/6301863/5f90d47dc8d1/ceem-17-265f1.jpg

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