在有或没有专门烧伤中心的医院中，烧伤患者入院时是否遵循严重烧伤转诊标准的紧急管理。
Adherence to the emergency management of severe burns referral criteria in burn patients admitted to a hospital with or without a specialized burn center.
机构信息
Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands; Burn Center, Maasstad Hospital, P.O. Box 9100, 3079 DZ Rotterdam, The Netherlands.
Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
出版信息
Burns. 2021 Dec;47(8):1810-1817. doi: 10.1016/j.burns.2021.02.023. Epub 2021 Mar 1.
BACKGROUND
The primary aim was to determine to what extent referral and admission of burn patients to a hospital with or without a burn center was in line with the EMSB referral criteria.
METHODS
This was a retrospective, multicenter cohort study. Burn patients admitted from 2014 to 2018 to a hospital in the Southwest Netherland trauma region and Network Emergency Care Brabant were included in this study. Outcome measures were the adherence to the EMSB referral criteria.
RESULTS
A total of 1790 patients were included, of whom 951 patients were primarily presented to a non-burn center. Of these patients, 666 (70.0%) were managed according to the referral criteria; 263 (27.7%) were appropriately not referred, 403 (42.4%) were appropriately referred. Twenty (2.1%) were overtransferred, and 265 (27.9%) undertransferred. In 1213 patients treated at a burn center 1119 (92.3%) met the referral criteria. Adherence was lowest for electrical (N = 4; 14.3%) and chemical burns (N = 16; 42.1%), and was highest in 'children ≥5% total body surface area (TBSA) burned' (N = 109; 83.2%).
CONCLUSION
The overall adherence to the referral criteria of patients presented to a non-burn center was fairly high. However, approximately 25% was not transferred to a burn center while meeting the criteria. Most improvement for individual criteria can be achieved in patients with electrical and chemical burns.
背景
主要目的是确定将烧伤患者转诊和收治到有或没有烧伤中心的医院的程度与 EMSB 转诊标准相符的程度。
方法
这是一项回顾性、多中心队列研究。本研究纳入了 2014 年至 2018 年期间从荷兰西南部创伤地区和 Network Emergency Care Brabant 医院收治的烧伤患者。主要结局指标是符合 EMSB 转诊标准的程度。
结果
共纳入 1790 例患者，其中 951 例患者最初就诊于非烧伤中心。这些患者中，有 666 例（70.0%）按照转诊标准进行了管理；263 例（27.7%）未被转诊是恰当的，403 例（42.4%）被转诊是恰当的。有 20 例（2.1%）是过度转诊，265 例（27.9%）是转诊不足。在 1213 例在烧伤中心治疗的患者中，有 1119 例（92.3%）符合转诊标准。对电气（N=4；14.3%）和化学烧伤（N=16；42.1%）的依从性最低，而对“儿童烧伤面积≥5%（TBSA）”（N=109；83.2%）的依从性最高。
结论
对非烧伤中心就诊患者转诊标准的总体符合率相当高。然而，约 25%的符合转诊标准的患者未被转诊至烧伤中心。对于电气和化学烧伤患者，大多数个体标准的改进都可以实现。
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