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直升机转运创伤患者的使用在全国范围内显著减少,但仍存在过度使用的情况。

Helicopter Transport Use for Trauma Patients Is Decreasing Significantly Nationwide but Remains Overutilized.

作者信息

Dhillon Navpreet K, Linaval Nikhil T, Patel Kavita A, Colovos Christos, Ko Ara, Margulies Daniel R, Ley Eric J, Barmparas Galinos

机构信息

Department of Surgery, Division of Trauma and Critical Care, Cedars-Sinai Medical Center, Los Angeles, California, USA.

出版信息

Am Surg. 2018 Oct 1;84(10):1630-1634.

Abstract

Rapid transfer of trauma patients to a trauma center for definitive management is essential to increase survival. The utilization of helicopter transportation for this purpose remains heavily debated. The purpose of this study was to characterize the trends in helicopter transportations of trauma patients in the United States over the last decade. Subjects with a primary mode of either ground or helicopter transportation were selected from the National Trauma Data Bank datasets 2007 to 2015. Over this period, the proportion of patients transported by a helicopter decreased significantly in a linear fashion from 17 per cent in 2007 to 10.2 per cent in 2015 ( < 0.001). The overall mortality of this population was 7.6 per cent and remained unchanged over the study period ( = 0.545). Almost 3 of 10 subjects (29.4%) transported by a helicopter had an Injury Severity Score <9. The proportion of elderly (>65 years) patients requiring helicopter transportation increased by 69.1 per cent, whereas their associated mortality decreased by 21.5 per cent. The use of a helicopter for the transportation of trauma patients has significantly decreased over the last decade without any significant change in mortality, possibly indicating more effective utilization of available resources. Overtriage of patients with minor injuries remained relatively unchanged.

摘要

将创伤患者迅速转运至创伤中心进行确定性治疗对于提高生存率至关重要。为此目的使用直升机运输仍存在激烈争论。本研究的目的是描述过去十年美国创伤患者直升机运输的趋势。从2007年至2015年的国家创伤数据库数据集中选取主要通过地面或直升机运输的患者。在此期间,通过直升机运输的患者比例从2007年的17%以线性方式显著下降至2015年的10.2%(<0.001)。该人群的总体死亡率为7.6%,在研究期间保持不变(=0.545)。通过直升机运输的近十分之三的受试者(29.4%)损伤严重度评分<9。需要直升机运输的老年(>65岁)患者比例增加了69.1%,而其相关死亡率下降了21.5%。在过去十年中,用于创伤患者运输的直升机使用量显著下降,而死亡率没有任何显著变化,这可能表明对可用资源的利用更加有效。轻伤患者的过度分诊相对保持不变。

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