Campagne Danielle, Cagle Kathleen, Castaneda Jannet, Weichenthal Lori, Young Megann, Anastopoulos Peter, Spano Susanne
Fresno Medical Education Program, University of California San Francisco (UCSF) Fresno, CA, United States.
J Emerg Trauma Shock. 2020 Oct-Dec;13(4):296-300. doi: 10.4103/JETS.JETS_152_19. Epub 2020 Dec 7.
Traction splint (TS) use during emergency medical system transport has been theorized to relieve pain, limit continued injury from loose bone fragments, and decrease potential bleeding space in the injured thigh.
This study aimed to evaluate the benefit of prehospital TS (PTS) application, using data from the trauma registry at a large Level 1 trauma center.
A retrospective review of patients from the NTRACS and Trauma One registry at an American College of Surgeons-verified Level 1 trauma center was conducted. All patients treated between the years 2001 and 2011 who were assigned a diagnosis International Classification of Diseases-9 code of 821.01 (closed fracture of shaft and femur) and 821.11 (open fracture of shaft and femur) (femur fracture [FF]) were included.
All categorical variables between the first groups were compared using Pearson's Chi-square and Fisher's exact test analysis. Comparisons were made using unpaired -tests and Mann-Whitney test or Kruskal-Wallis one-way ANOVA, followed by Dunn's pairwise comparisons.
Patients with a TS and those without indicated that the patients with no traction split (NTS) had sustained injuries beyond a FF (14.43 ± 9.740 vs. 18.59 ± 12.993, < 0.001). The three groups of TS placement (PTS, hospital, and NTS) only used patients with Injury Severity Score < 9 ( = 218). Hospital length of stay (LOS) was found to be significant ( = 0.05) between the patients who received a hospital TS (3.10 ± 1.709) and NTS (5.42 ± 5.144).
PTS can lower LOS and mortality. Further research is needed to confirm these findings.
在紧急医疗系统转运过程中使用牵引夹板(TS)的理论依据是缓解疼痛、限制游离骨碎片造成的持续损伤以及减少受伤大腿的潜在出血空间。
本研究旨在利用一家大型一级创伤中心创伤登记处的数据,评估院前应用TS(PTS)的益处。
对美国外科医师学会认证的一级创伤中心的NTRACS和Trauma One登记处的患者进行回顾性研究。纳入2001年至2011年间所有被分配国际疾病分类-9代码为821.01(股骨干闭合性骨折)和821.11(股骨干开放性骨折)(股骨骨折[FF])的患者。
使用Pearson卡方检验和Fisher精确检验分析比较第一组之间的所有分类变量。采用不成对t检验、Mann-Whitney检验或Kruskal-Wallis单因素方差分析进行比较,随后进行Dunn两两比较。
使用TS的患者和未使用TS的患者表明,未使用牵引夹板(NTS)的患者所受损伤超过股骨骨折(14.43±9.740对18.59±12.993,P<0.001)。三组TS放置情况(PTS、医院和NTS)仅纳入损伤严重程度评分<9分的患者(n = 218)。发现接受医院TS治疗的患者(3.10±1.709)与NTS患者(5.42±5.144)之间的住院时间(LOS)存在显著差异(P = 0.05)。
PTS可降低住院时间和死亡率。需要进一步研究来证实这些发现。