Moylan J A, Fitzpatrick K T, Beyer A J, Georgiade G S
Division of General and Thoracic Surgery, Duke University Medical Center, Durham, NC 27710.
Ann Surg. 1988 Jun;207(6):679-85. doi: 10.1097/00000658-198806000-00006.
This report analyzes the effect of air versus ground interhospital transport on survival following multisystem injury. There were 136 air-transported patients versus 194 ground-transported patients. The groups were similar in trauma scores, ages, mechanism of injury, and organ systems injured. There was a statistically significant survival advantage for air-transported patients with trauma scores between 10 and 5 (82.8% survival vs. 53.5%, p = less than 0.001). The time interval between accident and admission to the authors' institution was similar for both groups. Important therapeutic interventions contributing to better survival by the air-transported group included higher incidences of endotracheal intubation (50% vs. 25%), blood transfusions (32% vs. 10%), larger volumes of electrolyte fluid (3.3 L per patient vs. 2.1 L per patient) as well as the use of MAST trousers (60.3% vs. 34.9%). Transport charges for both ground and air services were similar. However, helicopter charges met only 15% of the operational budget of the aeromedical service. The remainder of the costs were generated from hospital patient revenues. Overall, total hospital charges were similar for both groups and were influenced by the variability of length of stay, particularly for orthopedic patients.
本报告分析了多系统损伤后空中与地面医院间转运对患者生存的影响。空中转运患者136例，地面转运患者194例。两组在创伤评分、年龄、损伤机制和受损器官系统方面相似。创伤评分为10至5分的空中转运患者有统计学显著的生存优势（生存率82.8% 对比53.5%，p小于0.001）。两组从事故到入住作者所在机构的时间间隔相似。空中转运组生存率更高的重要治疗干预措施包括气管插管发生率更高（50%对比25%）、输血（32%对比10%）、电解质液输入量更大（每位患者3.3升对比2.1升）以及使用抗休克裤（60.3%对比34.9%）。地面和空中服务的转运费用相似。然而，直升机费用仅占空中医疗服务运营预算的15%。其余费用来自医院患者收入。总体而言，两组的医院总费用相似，且受住院时间长短变化的影响，尤其是骨科患者。
