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院前转运方式对穿透性创伤患者死亡率的影响。

The Impact of Prehospital Transport Mode on Mortality of Penetrating Trauma Patients.

机构信息

Trauma and Orthopaedics Department, West Middlesex University Hospital, Chelsea and Westminster NHS Foundation Trust, Isleworth, United Kingdom.

General Surgery Department, Broomfield Hospital, Mid Essex Hospitals NHS Trust, Broomfield, United Kingdom.

出版信息

Air Med J. 2020 Nov-Dec;39(6):502-505. doi: 10.1016/j.amj.2020.07.005. Epub 2020 Aug 11.

Abstract

OBJECTIVE

The optimal mode of transport of trauma patients from the scene to the hospital remains unknown. We aimed to study the impact of different prehospital modes of transport of penetrating trauma patients on hospital mortality.

METHODS

Using the Trauma Quality Improvement Program 2010 to 2016 database, we identified all adults with a penetrating injury. Univariate then multivariable logistic regression analyses were performed to study the correlation between the mode of transport and in-hospital mortality, adjusting for several covariates.

RESULTS

A total of 92,427 subjects were included. The overall mean transport time for patients transported by a ground ambulance, helicopter, fixed wing ambulance, and police/private vehicle were 32.2, 61.2, 68.9, and 28.2 minutes, respectively. Multivariable analyses revealed that compared with ground ambulance, helicopter transport was associated with a 34% decrease in the odds of mortality (odds ratio = 0.66, P < .0001), whereas police transport and private vehicle transport were associated with a 52% decrease in the odds of mortality (odds ratio = 0.48, P < .0001).

CONCLUSION

Helicopter, police, and private vehicle transports are associated with a decreased odds of mortality compared with ground ambulance. Further research should examine the variation in levels of care within different modes of prehospital transport.

摘要

目的

创伤患者从现场到医院的最佳转运模式仍不清楚。我们旨在研究不同院前转运方式对穿透性创伤患者院内死亡率的影响。

方法

使用创伤质量改进计划 2010 年至 2016 年数据库,我们确定了所有患有穿透伤的成年人。使用单变量和多变量逻辑回归分析来研究转运方式与院内死亡率之间的相关性,调整了几个协变量。

结果

共纳入 92427 例患者。通过地面救护车、直升机、固定翼救护车和警车/私家车转运的患者的平均转运时间分别为 32.2、61.2、68.9 和 28.2 分钟。多变量分析显示,与地面救护车相比,直升机转运与死亡率降低 34%相关(比值比=0.66,P<0.0001),而警车转运和私家车转运与死亡率降低 52%相关(比值比=0.48,P<0.0001)。

结论

与地面救护车相比,直升机、警车和私家车转运与死亡率降低相关。进一步的研究应检查不同院前转运方式内在的护理水平差异。

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