Chen Kuo-Tai, Su Hsiu-Chen, Wu Nan-Chun, Hsu Chien-Chin, Lin Yi
Chi-Mei Medical Center Emergency Department Tainan Taiwan.
Taipei Medical University Department of Emergency Medicine, School of Medicine, College of Medicine Taipei Taiwan.
J Acute Med. 2020 Sep 1;10(3):99-105. doi: 10.6705/j.jacme.202009_10(3).0001.
It is crucial to identify the pivotal factors for transferring patients with major trauma. We aim to delineate the clinical features and required aids of severe trauma patients and identify the differences between those who were admitted directly to a trauma center and those transferred from other hospitals.
We retrospectively reviewed all hospitalized trauma patients discharged from the ward in Chi-Mei Medical Center from January 1, 2017 to December 31, 2018. Of 5,846 patients, we identified 1,061 patients with Injury Severity Score >15, of which 92 patients were transferred from two branch hospitals (branch group), 172 patients were transferred from other hospitals (other group), and 797 patients were admitted directly through the emergency department (control group). We compared the clinical variables between control and the other two groups.
The branch group included a high proportion of pediatric patients (control: 1.8%, other: 2.3%, and branch: 6.5%). The branch group demonstrated higher requirements for life-saving interventions and arterial embolization (branch vs. control, life-saving interventions: 26.1% vs. 17.6%, = 0.046; arterial embolization: 9.8% vs. 3.5%, = 0.004). However, no statistically significant differences were observed between the control group and other group in terms of requirements of life-saving interventions. The prognoses were similar between the groups.
Our trauma center can provide pediatric trauma care and timely life-saving interventions to help severe trauma patients transferred from other hospitals. The branch hospitals benefit mostly from the aid. Better network connection and information sharing between hospitals might play crucial roles in the management of transferred severe trauma patients.
确定重伤患者转运的关键因素至关重要。我们旨在描述严重创伤患者的临床特征和所需辅助手段,并确定直接入住创伤中心的患者与从其他医院转运而来的患者之间的差异。
我们回顾性分析了2017年1月1日至2018年12月31日从奇美医学中心病房出院的所有住院创伤患者。在5846例患者中,我们确定了1061例损伤严重程度评分>15的患者,其中92例从两家分院转运而来(分院组),172例从其他医院转运而来(其他组),797例通过急诊科直接入院(对照组)。我们比较了对照组与其他两组之间的临床变量。
分院组儿童患者比例较高(对照组:1.8%,其他组:2.3%,分院组:6.5%)。分院组对救生干预和动脉栓塞的需求更高(分院组与对照组相比,救生干预:26.1%对17.6%,P = 0.046;动脉栓塞:9.8%对3.5%,P = 0.004)。然而,在救生干预需求方面,对照组与其他组之间未观察到统计学显著差异。各组之间的预后相似。
我们的创伤中心可以提供儿童创伤护理和及时的救生干预措施,以帮助从其他医院转运来的严重创伤患者。分院从这种援助中受益最大。医院之间更好的网络连接和信息共享可能在转运严重创伤患者的管理中发挥关键作用。