Trauma and Orthopaedics Department, West Middlesex University Hospital, Isleworth, UK.
Air Med J. 2020 Sep-Oct;39(5):374-379. doi: 10.1016/j.amj.2020.05.018. Epub 2020 Jun 19.
The time spent on scene by emergency medical services remains highly variable. We sought to investigate how much of the prehospital scene time variation in penetrating trauma patients could be explained by prehospital factors.
Using the 2010 to 2016 Trauma Quality and Improvement database, all adult penetrating trauma patients were included. The prehospital scene time was defined as the time from emergency medical service scene arrival to departure. Using all Trauma Quality and Improvement database variables including patient, injury (eg, Injury Severity Score), geography, and logistical (eg, transport mode) factors, multivariable linear regression models were created to predict the prehospital scene time. The prehospital scene time was treated as a continuous variable, and the degree to which the models could explain the variation in scene time was measured using the coefficient of determination (R).
A total of 45,560 patients were included. The median prehospital scene time was 6 minutes (interquartile range, 3-10 minutes). The R for factors in the multivariable regression model was 0.06, suggesting that 94% of the prehospital scene time variation cannot be explained by the wide range of prehospital factors.
Most of the variation in prehospital scene time cannot be explained by injury characteristics. The variation may be caused by logistical delays or system-related factors.
急救医疗服务在现场所花费的时间仍然高度可变。我们试图调查有多少穿透性创伤患者的院前现场时间变化可以用院前因素来解释。
使用 2010 年至 2016 年创伤质量和改进数据库，纳入所有成人穿透性创伤患者。院前现场时间定义为从急救医疗服务现场到达到离开的时间。使用包括患者、损伤（例如，损伤严重程度评分）、地理和后勤（例如，运输方式）因素在内的所有创伤质量和改进数据库变量，创建多变量线性回归模型来预测院前现场时间。将院前现场时间视为连续变量，并使用确定系数（R）衡量模型解释现场时间变化的程度。
共纳入 45560 例患者。院前现场时间中位数为 6 分钟（四分位间距，3-10 分钟）。多变量回归模型中因素的 R 值为 0.06，这表明 94%的院前现场时间变化无法用广泛的院前因素来解释。
大多数院前现场时间的变化无法用损伤特征来解释。这种变化可能是由后勤延误或与系统相关的因素引起的。
