Zhengzhou First People's Hospital, Zhengzhou, 450004, China.
Zhengzhou Central Hospital, Central Hospital of Zhengzhou University, Zhengzhou, 450007, China.
Chin J Traumatol. 2021 Feb;24(1):45-47. doi: 10.1016/j.cjtee.2020.11.004. Epub 2020 Nov 13.
It is a challenge for the primary hospitals to manage multiple trauma patients. In this article, we explored the advantage of establishing a surgical intensive care unit (SICU) predominant by cardiothoracic surgeons in the early management of multiple trauma.
This was a retrospective study and patients with multiple trauma in our hospital were collected and divided into two groups, based on time period and treat modes: group A (retrospective observation group) where patients were treated with the traditional treatment mode from January 2017 to December 2017 and group B (study group) where patients were treated in the SICU predominant by cardiothoracic surgeons from January 2018 to December 2018. Clinical data including demographics, injury severity score (ISS), causes of injury, time intervals from reception to entering SICU or operating room and mortality three days after injuries were collected. Data were analyzed by SPSS 20.0 software. Categorical variables were presented as number and/or frequency and continuous variables as mean ± SD.
Altogether 406 patients were included in this study, including 217 patients in group A and 189 patients in group B. General data between the two groups revealed no significant difference: mean age (years) (35.51 ± 12.97 vs. 33.62 ± 13.61, p = 0.631), gender distribution (mean/female, 130/87 vs. 116/73, p = 0.589) and ISS (15.92 ± 7.95 vs. 16.16 ± 6.89, p = 0.698). Fall from height were the dominant mechanism of injury, with 135 cases in group A (71.4%) and 121 cases in group B (55.8%), followed by traffic accidents. Injury mechanism showed no significant differences between two groups (p = 1.256). Introduction of the SICU significantly improved the care of trauma patients, regarding speed and mortality. Time intervals between reception and entering SICU or operating room was (108.23 ± 6.72) min and (45.67 ± 7.96) min in group A and B, respectively (p = 0.001). Mortality three days after injuries was 13.89% and 5.53% in group A and B, respectively (p = 0.005).
Establishing a SICU predominant by cardiothoracic surgeons can reduce the early mortality rates in multiple trauma patients.
基层医院处理多发创伤患者具有挑战性。本文旨在探讨以心胸外科医师为主导的外科重症监护病房（SICU）在多发创伤早期处理中的优势。
这是一项回顾性研究，收集我院多发创伤患者，根据时间段和治疗模式分为两组：A 组（回顾性观察组），患者于 2017 年 1 月至 2017 年 12 月采用传统治疗模式；B 组（研究组），患者于 2018 年 1 月至 2018 年 12 月以心胸外科医师为主导的 SICU 进行治疗。收集患者的人口统计学资料、损伤严重程度评分（ISS）、损伤原因、从接诊到进入 SICU 或手术室的时间间隔以及伤后 3 天的死亡率等临床资料。采用 SPSS 20.0 软件进行数据分析。分类变量用例数或频率表示，连续变量用均数±标准差表示。
本研究共纳入 406 例患者，其中 A 组 217 例，B 组 189 例。两组患者一般资料比较差异无统计学意义：年龄（岁）[（35.51±12.97）岁比（33.62±13.61）岁，p=0.631]、性别（男/女，例数）[130/87 比 116/73，p=0.589]和 ISS[（15.92±7.95）分比（16.16±6.89）分，p=0.698]。高处坠落伤为主要致伤机制，A 组 135 例（71.4%），B 组 121 例（55.8%）；其次为交通伤。两组致伤机制比较差异无统计学意义（p=1.256）。SICU 的引入显著提高了创伤患者的救治速度和降低了死亡率。A 组和 B 组从接诊到进入 SICU 或手术室的时间间隔分别为（108.23±6.72）min 和（45.67±7.96）min（p=0.001）。伤后 3 天死亡率分别为 13.89%和 5.53%（p=0.005）。
以心胸外科医师为主导的 SICU 可降低多发创伤患者的早期死亡率。
