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新型冠状病毒肺炎大流行第一波和第二波对德国创伤网络DGU中严重创伤及护理结构的影响

Impact of the First and Second Wave of the SARS-CoV-2 Pandemic on Severe Trauma and the Care Structures in the German TraumaNetzwerk DGU.

作者信息

Colcuc Christian, Fischer Sebastian, Leimkühler Philipp, Miersbach Marco, Lefering Rolf, Dgu TraumaRegister, Wähnert Dirk, Vordemvenne Thomas, Grüneweller Niklas

机构信息

Department of Trauma Surgery and Orthopedics, Protestant Hospital of Bethel Foundation, University Hospital OWL of Bielefeld University, Campus Bielefeld-Bethel, 33617 Bielefeld, Germany.

Department of Foot and Ankle Surgery, Berufsgenossenschaftliche Unfallklinik Frankfurt am Main, 60389 Frankfurt, Germany.

出版信息

J Clin Med. 2022 Nov 28;11(23):7036. doi: 10.3390/jcm11237036.

Abstract

(1) Background: The aim of this study was to investigate the effects of the pandemic on transfer rates of severely injured patients within the German TraumaNetzwerk of the DGU. Furthermore, cause of accident, rescue times, and trauma cases are compared to pre-pandemic times. (2) Methods: For this investigation patients documented in the TraumaRegister DGU from 2018 to 2020 were analyzed. The years 2018 and 2019 served as a comparison to 2020, the first COVID-19 pandemic year. All primary admissions and transfers were included if treated on an intensive care unit. (3) Results: Demographics (age, sex) and injury severity in 2020 were comparable with 2018/2019. In 2020, a significant decrease (3.7%) in car accidents was found. In contrast, a significant increase (3.2%) in bicycle accidents was seen. During the second wave, there was a significant burden of COVID-19 patients on hospitals. In this time, we found a significant increase in early transfers of trauma patients primarily from small level 3 to large level 1 centers. There was also a small but significant increase in rescue time, especially during the 2nd wave. (4) Conclusions: Our data confirm the importance of the network structures established in the TraumaNetzwerk DGU, especially during the pandemic. The established structures allow smaller hospitals to spread their resources and prevent internal collapse. Therefore, the structures of the TraumaNetzwerk DGU play a prominent role in stabilizing the healthcare system by helping to maintain both surgical and critical care capacity and providing adequate emergency care.

摘要

(1) 背景:本研究旨在调查疫情对德国创伤协会(DGU)创伤网络内重伤患者转运率的影响。此外,还将事故原因、救援时间和创伤病例与疫情前时期进行了比较。(2) 方法:为进行此项调查,分析了2018年至2020年创伤登记DGU中记录的患者。将2018年和2019年作为与2020年(新冠疫情的第一年)的对照。所有在重症监护病房接受治疗的首次入院和转运病例均纳入研究。(3) 结果:2020年的人口统计学特征(年龄、性别)和损伤严重程度与2018/2019年相当。2020年,汽车事故显著减少(3.7%)。相比之下,自行车事故显著增加(3.2%)。在第二波疫情期间,医院承受了新冠患者的巨大负担。在此期间,我们发现创伤患者早期转运显著增加,主要是从小型三级中心转至大型一级中心。救援时间也有小幅但显著的增加,尤其是在第二波疫情期间。(4) 结论:我们的数据证实了DGU创伤网络中建立的网络结构的重要性,尤其是在疫情期间。已建立的结构使较小的医院能够分散其资源,防止内部崩溃。因此,DGU创伤网络的结构在稳定医疗系统方面发挥了重要作用,有助于维持外科和重症监护能力,并提供充分的紧急护理。

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