Scharringa Samantha, Dijkink Suzan, Krijnen Pieta, Schipper Inger B
Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands.
Department of Surgery, Haaglanden Medical Center, The Hague, The Netherlands.
Eur J Trauma Emerg Surg. 2024 Apr;50(2):405-416. doi: 10.1007/s00068-023-02282-0. Epub 2023 May 30.
To provide an overview of trauma system maturation in Europe.
Maturation was assessed using a self-evaluation survey on prehospital care, facility-based trauma care, education/training, and quality assurance (scoring range 3-9 for each topic), and key infrastructure elements (scoring range 7-14) that was sent to 117 surgeons involved in trauma, orthopedics, and emergency surgery, from 24 European countries. Average scores per topic were summed to create a total score on a scale from 19 to 50 per country. Scores were compared between countries and between geographical regions, and correlations between scores on different sections were assessed.
The response rate was 95%. On the scale ranging from 19 to 50, the mean (SD, range) European trauma system maturity score was 38.5 (5.6, 28.2-48.0). Prehospital care had the highest mean score of 8.2 (0.5, 6.9-9.0); quality assurance scored the lowest 5.9 (1.7, 3.2-8.5). Facility-based trauma care was valued 6.9 (1.4, 4.1-9.0), education and training 7.0 (1.2, 5.2-9.0), and key infrastructure elements 10.3 (1.6, 7.6-13.5). All aspects of trauma care maturation were strongly correlated (r > 0.6) except prehospital care. End scores of Northern countries scored significantly better than Southern countries (p = 0.03).
The level of development of trauma care systems in Europe varies greatly. Substantial improvements in trauma systems in several European countries are still to be made, especially regarding quality assurance and key infrastructure elements, such as implementation of a lead agency to oversee the trauma system, and funding for growth, innovation and research.
概述欧洲创伤系统的成熟情况。
采用一项关于院前护理、基于机构的创伤护理、教育/培训和质量保证（每个主题的评分范围为3 - 9）以及关键基础设施要素（评分范围为7 - 14）的自我评估调查来评估成熟度，该调查发送给了来自24个欧洲国家的117名从事创伤、骨科和急诊外科的外科医生。每个主题的平均得分相加，得出每个国家在19至50分范围内的总分。比较了不同国家和不同地理区域的得分，并评估了不同部分得分之间的相关性。
回复率为95%。在19至50分的范围内，欧洲创伤系统成熟度的平均（标准差，范围）得分为38.5（5.6，28.2 - 48.0）。院前护理的平均得分最高，为8.2（0.5，6.9 - 9.0）；质量保证得分最低，为5.9（1.7，3.2 - 8.5）。基于机构的创伤护理得分为6.9（1.4，4.1 - 9.0），教育和培训为7.0（1.2，5.2 - 9.0），关键基础设施要素为10.3（1.6，7.6 - 13.5）。除院前护理外，创伤护理成熟度的所有方面都高度相关（r > 0.6）。北欧国家的最终得分显著高于南欧国家（p = 0.03）。
欧洲创伤护理系统的发展水平差异很大。欧洲几个国家的创伤系统仍需大幅改进，特别是在质量保证和关键基础设施要素方面，例如设立一个牵头机构来监督创伤系统，以及为发展、创新和研究提供资金。
