Bläsius Felix Marius, Horst Klemens, Brokmann Jörg Christian, Lefering Rolf, Andruszkow Hagen, Hildebrand Frank
Department of Trauma and Reconstructive Surgery, University Hospital RWTH, 52074 Aachen, Germany.
Emergency Department, University Hospital RTWH, 52074 Aachen, Germany.
J Clin Med. 2021 Feb 18;10(4):837. doi: 10.3390/jcm10040837.
(1) Background: Data on the effects of helicopter emergency medical service (HEMS) transport and treatment on the survival of severely injured pediatric patients in high-level trauma centers remain unclear. (2) Methods: A national dataset from the TraumaRegister DGU was used to retrospectively compare the mortality rates among severely injured pediatric patients (1-15 years) who were transported by HEMS to those transported by ground emergency medical service (GEMS) and treated at trauma centers of different treatment levels (levels I-III). (3) Results: In total, 2755 pediatric trauma patients (age: 9.0 ± 4.8 years) were included in this study over five years. Transportation by HEMS resulted in a significant survival benefit compared to GEMS (odds ratio (OR) 0.489; 95% confidence interval (CI): 0.282-0.850). Pediatric trauma patients treated in level II or III trauma centers showed 34% and fourfold higher in-hospital mortality risk than those in level I trauma centers (level II: OR 1.34, 95% CI: 0.70-2.56; level III: OR 4.63, 95% CI: 1.33-16.09). (4) Conclusions: In our national pediatric trauma cohort, both HEMS transportation and treatment in level I trauma centers were independent factors of improved survival in pediatric trauma patients.
(1) 背景：关于直升机紧急医疗服务（HEMS）转运和治疗对高级别创伤中心严重受伤儿科患者生存率影响的数据仍不明确。(2) 方法：使用来自创伤登记数据库DGU的全国数据集，回顾性比较由HEMS转运的严重受伤儿科患者（1至15岁）与由地面紧急医疗服务（GEMS）转运并在不同治疗级别（I至III级）创伤中心接受治疗的患者的死亡率。(3) 结果：在五年期间，本研究共纳入2755例儿科创伤患者（年龄：9.0±4.8岁）。与GEMS相比，HEMS转运带来了显著的生存获益（优势比（OR）0.489；95%置信区间（CI）：0.282 - 0.850）。在II级或III级创伤中心接受治疗的儿科创伤患者的院内死亡风险比I级创伤中心的患者分别高34%和四倍（II级：OR 1.34，95% CI：0.70 - 2.56；III级：OR 4.63，95% CI：1.33 - 16.09）。(4) 结论：在我们的全国儿科创伤队列中，HEMS转运和在I级创伤中心治疗都是提高儿科创伤患者生存率的独立因素。
