Department of Trauma Surgery, Amsterdam University Medical Center, location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
Department of Anesthesiology, Amsterdam University Medical Center, location VUmc, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands.
BMC Emerg Med. 2021 Jul 6;21(1):78. doi: 10.1186/s12873-021-00476-6.
The time from injury to treatment is considered as one of the major determinants for patient outcome after trauma. Previous studies already attempted to investigate the correlation between prehospital time and trauma patient outcome. However, the outcome for severely injured patients is not clear yet, as little data is available from prehospital systems with both Emergency Medical Services (EMS) and physician staffed Helicopter Emergency Medical Services (HEMS). Therefore, the aim was to investigate the association between prehospital time and mortality in polytrauma patients in a Dutch level I trauma center.
A retrospective study was performed using data derived from the Dutch trauma registry of the National Network for Acute Care from Amsterdam UMC location VUmc over a 2-year period. Severely injured polytrauma patients (Injury Severity Score (ISS) ≥ 16), who were treated on-scene by EMS or both EMS and HEMS and transported to our level I trauma center, were included. Patient characteristics, prehospital time, comorbidity, mechanism of injury, type of injury, HEMS assistance, prehospital Glasgow Coma Score and ISS were analyzed using logistic regression analysis. The outcome measure was in-hospital mortality.
In total, 342 polytrauma patients were included in the analysis. The total mortality rate was 25.7% (n = 88). Similar mean prehospital times were found between the surviving and non-surviving patient groups, 45.3 min (SD 14.4) and 44.9 min (SD 13.2) respectively (p = 0.819). The confounder-adjusted analysis revealed no significant association between prehospital time and mortality (p = 0.156).
This analysis found no association between prehospital time and mortality in polytrauma patients. Future research is recommended to explore factors of influence on prehospital time and mortality.
从受伤到治疗的时间被认为是创伤后患者预后的主要决定因素之一。先前的研究已经尝试调查院前时间与创伤患者预后之间的相关性。然而，对于严重受伤的患者，由于从配备有急诊医疗服务（EMS）和医生的直升机紧急医疗服务（HEMS）的院前系统获得的数据很少，因此结果尚不清楚。因此，目的是调查荷兰一级创伤中心的多发伤患者的院前时间与死亡率之间的关系。
使用来自阿姆斯特丹 UMC 地点 VUmc 的国家急性护理网络荷兰创伤登记处的 2 年数据进行回顾性研究。纳入在现场接受 EMS 或 EMS 和 HEMS 治疗并转运至我们一级创伤中心的严重多发伤患者（损伤严重程度评分（ISS）≥16）。使用逻辑回归分析分析患者特征、院前时间、合并症、损伤机制、损伤类型、HEMS 协助、院前格拉斯哥昏迷评分和 ISS。观察指标为院内死亡率。
共纳入 342 例多发伤患者进行分析。总死亡率为 25.7%（n=88）。存活组和非存活组的平均院前时间相似，分别为 45.3 分钟（SD 14.4）和 44.9 分钟（SD 13.2）（p=0.819）。混杂因素调整分析显示，院前时间与死亡率之间无显著相关性（p=0.156）。
本分析未发现多发伤患者的院前时间与死亡率之间存在关联。建议进行进一步的研究，以探讨影响院前时间和死亡率的因素。
