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创伤与非创伤患者接受丹麦直升机紧急医疗服务治疗的比较:基于登记的患者特征、住院和死亡率研究。

Trauma Versus Nontrauma Patients Treated by the Danish Helicopter Emergency Medical Service: A Register-Based Study of Patient Characteristics, Hospitalization, and Mortality.

机构信息

Department of Research and Development, Pre-hospital Emergency Medical Services, Central Denmark Region, Aarhus, Denmark.

Department of Research and Development, Pre-hospital Emergency Medical Services, Central Denmark Region, Aarhus, Denmark; Department of Anaesthesiology, Aarhus University Hospital, Aarhus, Denmark; The Danish Air Ambulance, Aarhus, Denmark.

出版信息

Air Med J. 2021 Sep-Oct;40(5):325-330. doi: 10.1016/j.amj.2021.05.005. Epub 2021 Jun 22.

Abstract

OBJECTIVE

Helicopter emergency medical services (HEMS) are part of many emergency health care systems, ensuring specialized treatment on scene. An accurate use is important for improved resource utilization. The aim of this study was to describe patient characteristics, hospitalization, and mortality in trauma and nontrauma patients seen by the Danish HEMS teams.

METHODS

The study is a registry-based study presenting data from the national Danish HEMS database. We included all HEMS missions from October 1, 2014, to April 30, 2018.

RESULTS

A total of 13,391 HEMS entries were registered, and 5,524 cases were included in the study. Trauma patients were younger (38 vs. 63 years) and had a lower level of comorbidities (Charlson Comorbidity Index 0: 82% vs. 58%) compared with nontrauma patients. More nontrauma cases were classified with a severity score corresponding to a critical emergency. They also had a higher 30-day mortality compared with trauma patients (26% vs. 11%).

CONCLUSION

This national study demonstrated differences in demographics, the severity profile, and mortality among trauma compared with nontrauma patients that could possibly indicate an overuse of HEMS for minor trauma cases. The results might suggest that educational efforts and a review of the current dispatch guidelines could be of importance when trying to improve the use of HEMS.

摘要

目的

直升机紧急医疗服务(HEMS)是许多紧急医疗保健系统的一部分,可确保在现场进行专业治疗。准确使用 HEMS 对于改善资源利用非常重要。本研究的目的是描述丹麦 HEMS 小组接诊的创伤和非创伤患者的患者特征、住院和死亡率。

方法

本研究是一项基于登记的研究,展示了来自丹麦全国 HEMS 数据库的数据。我们纳入了 2014 年 10 月 1 日至 2018 年 4 月 30 日期间所有的 HEMS 任务。

结果

共登记了 13391 例 HEMS 记录,其中 5524 例纳入研究。与非创伤患者相比,创伤患者更年轻(38 岁 vs. 63 岁),合并症水平较低(Charlson 合并症指数 0:82% vs. 58%)。更多的非创伤患者被归类为严重程度评分对应于危急紧急情况。他们的 30 天死亡率也高于创伤患者(26% vs. 11%)。

结论

这项全国性研究表明,与创伤患者相比,非创伤患者在人口统计学特征、严重程度谱和死亡率方面存在差异,这可能表明 HEMS 在轻微创伤病例中的使用过度。结果表明,在尝试改善 HEMS 使用时,教育工作和对当前调度指南的审查可能很重要。

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