以色列国防军创伤登记处：22 年的伤时数据。
The Israel Defense Forces Trauma Registry: 22 years of point-of-injury data.
机构信息
From the Israel Defense Forces Medical Corps (A.M.T., R.N., D.L., T.B., A.B., E.G., J.C.), Tel Hashomer, Ramat Gan; Department of General Surgery and Transplantation-Surgery B (R.N.), Chaim Sheba Medical Center, Tel Hashomer, Affiliated to Sackler School of Medicine, Tel Aviv; Department of Emergency Medicine (A.M.L.), Rambam Health Care Campus, Haifa; The Azrieli Faculty of Medicine (A.B., E.G.), Bar-Ilan University, Safed, Israel; and The Uniformed Services University of the Health Sciences (E.G.), Bethesda, Maryland.
出版信息
J Trauma Acute Care Surg. 2020 Aug;89(2S Suppl 2):S32-S38. doi: 10.1097/TA.0000000000002776.
BACKGROUND
Trauma is the leading cause of death among casualties between 1 and 44 years. A large proportion of trauma deaths occurs even before arriving at a medical facility. The paucity of prehospital data is a major reason for the lagging development of prehospital trauma care research. This study aims to describe the Israel Defense Forces Prehopistal Trauma Registry, the steps taken to improve data collection and quality, the resulting trends, and the registry's contribution to policymaking.
METHODS
This study explores the quantity and quality of point of injury and prehospital data in the registry between the years 1997 and 2018. We assessed the number of recorded casualties per year, casualties characteristics, and documentation variables in the registry, with a specific focus on documentation of vital signs throughout the years.
RESULTS
Overall, 17,905 casualties were recorded. Most casualties were young males (88.6%)-military personnel (52.7%), Syrian refugees (16.2%), Israeli civilians (11.5%), and Palestinians (9.0%). The median number of annual records from 2006 onward was significantly higher compared with before 2006 (1,000 [IQR, 792-1,470] vs. 142 [IQR, 129-156]). Between 2010 and 2018, documentation rate increased in all vital signs investigated including heart rate (56.3% vs. 1.0%), level of consciousness (55.1% vs. 0.3%), respiratory rate (51.8% vs. 0.3%), blood oxygen saturation (50.0% vs. 1.0%), Glasgow Coma Scale (48.2% vs. 0.4%), systolic blood pressure (45.7% vs. 0.8%), and pain (19.1% vs. 0.5%).
CONCLUSION
Point of injury and prehospital documentation are rare yet essential for ongoing improvement of combat casualty care. The Israel Defense Forces Trauma Registry is one of the largest and oldest prehospital computerized military trauma registries in the world. This study shows a major improvement in the quantity and then in the quality of prehospital documentation throughout the years that affected guidelines and policy. Further work will focus on improving data completeness and accuracy.
LEVEL OF EVIDENCE
Retrospective study, level III.
背景
创伤是 1 至 44 岁人群中伤亡的主要原因。很大一部分创伤死亡发生在到达医疗机构之前。缺乏院前数据是院前创伤救治研究滞后的主要原因。本研究旨在描述以色列国防军院前创伤登记处，为改善数据收集和质量所采取的步骤，由此产生的趋势，以及该登记处对决策制定的贡献。
方法
本研究探讨了 1997 年至 2018 年登记处中伤处和院前数据的数量和质量。我们评估了每年记录的伤亡人数、伤亡人员特征和登记处中的文档变量，特别关注多年来生命体征的记录情况。
结果
总体而言，共记录了 17905 名伤员。大多数伤员是年轻男性（88.6%）-军人（52.7%）、叙利亚难民（16.2%）、以色列平民（11.5%）和巴勒斯坦人（9.0%）。2006 年以后每年记录的中位数明显高于 2006 年以前（1000[IQR，792-1470]与 142[IQR，129-156]）。2010 年至 2018 年，所有调查的生命体征的记录率均有所增加，包括心率（56.3%比 1.0%）、意识水平（55.1%比 0.3%）、呼吸频率（51.8%比 0.3%）、血氧饱和度（50.0%比 1.0%）、格拉斯哥昏迷量表（48.2%比 0.4%）、收缩压（45.7%比 0.8%）和疼痛（19.1%比 0.5%）。
结论
伤处和院前记录很少，但对于不断改进战伤救治至关重要。以色列国防军创伤登记处是世界上最大和最古老的计算机化军事创伤登记处之一。本研究表明，多年来，院前记录的数量和质量都有了显著提高，这影响了指南和政策。进一步的工作将集中在提高数据的完整性和准确性上。
证据水平
回顾性研究，III 级。
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