National Trauma Research Institute, Melbourne 3004, Australia.
Trauma Service, The Alfred Hospital, Melbourne 3004, Australia.
Medicina (Kaunas). 2019 Aug 30;55(9):551. doi: 10.3390/medicina55090551.
: Major trauma centres manage severely injured patients using multi-disciplinary teams but the evidence-base that targeted Trauma Team Training (TTT) improves patients' outcomes is unclear. This systematic review aimed to identify the association between the implementation of TTT programs and patient outcomes. We searched OVID Medline, PubMed and The Cochrane Library (CENTRAL) from the date of the database commencement until 10 of April 2019 for a combination of Medical Subject Headings (MeSH) terms and keywords relating to TTT and clinical outcomes. Reference lists of appraised studies were also screened for relevant articles. We extracted data on the study setting, type and details about the learners, as well as clinical outcomes of mortality and/or time to critical interventions. A meta-analysis of the association between TTT and mortality was conducted using a random effects model. The search yielded 1136 unique records and abstracts, of which 18 full texts were reviewed. Nine studies met final inclusion, of which seven were included in a meta-analysis of the primary outcome. There were no randomised controlled trials. TTT was not associated with mortality (Pooled overall odds ratio (OR) 0.83; 95% Confidence Interval; 0.64-1.09). TTT was associated with improvements in time to operating theatre and time to first computerized tomography (CT) scanning. Despite few publications related to TTT, its introduction was associated with improvements in time to critical interventions. Whether such improvements can translate to improvements in patient outcomes remains unknown. Further research focusing on the translation of standardised trauma team reception "actions" into TTT is required to assess the association between TTT and patient outcome.
: 严重创伤中心通过多学科团队管理严重受伤患者，但有针对性的创伤团队培训（TTT）是否能改善患者结局的证据尚不清楚。本系统评价旨在确定 TTT 方案的实施与患者结局之间的关联。我们检索了 OVID Medline、PubMed 和 The Cochrane Library（CENTRAL），从数据库启动日期到 2019 年 4 月 10 日，检索了与 TTT 和临床结局相关的医学主题词（MeSH）术语和关键词的组合。还对评价研究的参考文献进行了筛选，以寻找相关文章。我们提取了关于研究设置、学习者类型和细节以及死亡率和/或关键干预时间的临床结局的数据。使用随机效应模型对 TTT 与死亡率之间的关联进行了荟萃分析。该检索产生了 1136 条独特的记录和摘要，其中 18 篇全文进行了回顾。9 项研究最终符合纳入标准，其中 7 项研究纳入了主要结局的荟萃分析。没有随机对照试验。TTT 与死亡率无关（汇总总体优势比（OR）0.83；95%置信区间；0.64-1.09）。TTT 与进入手术室和首次计算机断层扫描（CT）扫描的时间有关。尽管与 TTT 相关的出版物很少，但它的引入与关键干预时间的改善有关。这些改进是否能转化为患者结局的改善尚不清楚。需要进一步研究将标准化创伤团队接待“行动”转化为 TTT，以评估 TTT 与患者结局之间的关联。
