Medical Modeling, Simulation, and Mission Support, Naval Health Research Center, San Diego, California, USA.
Leidos Inc, San Diego, California, USA.
BMJ Mil Health. 2023 May;169(e1):e34-e38. doi: 10.1136/bmjmilitary-2020-001542. Epub 2021 Jan 22.
The '' is a universal paradigm that suggests trauma patients have lower morbidity and mortality when provided with medical care within 1 hour after injury. The objective of this study was to examine whether transport time from point of injury to a military treatment facility (MTF) in-theatre was associated with patient-reported outcomes, such as post-traumatic stress disorder (PTSD), depression and quality of life (QOL), among US service members with combat-related injury.
Participants were injured between March 2003 and March 2016 and completed standardised assessments of PTSD, depression and QOL for theWounded Warrior Recovery Project (WWRP) between January 2013 and November 2017. Multivariable regressions were used to assess the relationship between transport time (≤1 hour or >1 hour from injury to MTF) and positive screens for PTSD and depression, and QOL, respectively.Overall, 45.6% of participants (n=879) arrived at an MTF within 1 hour postinjury. About 8 years passed between when participants were injured on deployment and when they completed their first WWRP assessment. Approximately 48% of participants screened positive for PTSD and 51.3% for depression, with a mean QOL score of 0.513 (SD=0.150). After adjusting for covariates, transport time was not significantly associated with PTSD (OR 1.04, 95% CI 0.79 to 1.38; p=0.77), depression (OR 0.92, 95% CI 0.69 to 1.21; p=0.55) or QOL (β=0.009; p=0.38).
Transport time was not associated with patient-reported outcomes among US service members with combat-related injury. These findings are important as we seek to understand how combat casualties may be affected by extended medical evacuation or transport times anticipated in future expeditionary operations.
“黄金一小时”是一个普遍的范式，它表明创伤患者在受伤后 1 小时内接受医疗护理时，发病率和死亡率较低。本研究的目的是检验从受伤点到军事治疗设施（MTF）的运输时间是否与美国参战军人的创伤后应激障碍（PTSD）、抑郁和生活质量（QOL）等患者报告的结果相关。
参与者于 2003 年 3 月至 2016 年 3 月期间受伤，并于 2013 年 1 月至 2017 年 11 月期间完成了“受伤勇士康复项目（WWRP）”的 PTSD、抑郁和 QOL 标准评估。使用多变量回归来评估运输时间（受伤至 MTF 的时间≤1 小时或＞1 小时）与 PTSD 和抑郁的阳性筛查结果以及 QOL 之间的关系。
总体而言，45.6%的参与者（n=879）在受伤后 1 小时内到达 MTF。参与者在部署中受伤和完成首次 WWRP 评估之间大约过去了 8 年。大约 48%的参与者 PTSD 筛查阳性，51.3%的参与者抑郁筛查阳性，平均 QOL 得分为 0.513（SD=0.150）。在调整了协变量后，运输时间与 PTSD 无显著相关性（OR 1.04，95%CI 0.79 至 1.38；p=0.77）、抑郁（OR 0.92，95%CI 0.69 至 1.21；p=0.55）或 QOL（β=0.009；p=0.38）。
在与战斗相关的受伤的美国军人中，运输时间与患者报告的结果无关。这些发现很重要，因为我们试图了解在未来的远征行动中，延长医疗后送或运输时间可能如何影响战斗伤亡人员。
