交通方式对孤立性穿透性躯干创伤后死亡率的影响。
The effect of transport mode on mortality following isolated penetrating torso Trauma.
机构信息
Department of Surgery, University of North Carolina at Chapel Hill, United States.
Department of Surgery, University of North Carolina at Chapel Hill, United States.
出版信息
Am J Surg. 2023 Oct;226(4):542-547. doi: 10.1016/j.amjsurg.2023.06.033. Epub 2023 Jun 29.
BACKGROUND
Prehospital interventions may increase the time to definitive care. Compared to ground ambulance, we hypothesize improved mortality for patients with isolated, penetrating torso injuries transported via private vehicle.
METHODS
We reviewed the National Trauma Data Bank (2017-2021) for adults with isolated, penetrating torso injuries stratified by mechanism (stabbing vs. firearm) and transport mode (private vehicle vs. ground ambulance). We performed a multivariable logistic regression to estimate the effect of transport mode on mortality.
RESULTS
48,444 patients met our inclusion criteria. Patients transported by ambulance, injured by stabbing (n = 26,633) and by firearm (n = 21,811) had adjusted odds ratios of 1.81 (95%CI 1.05-3.14, p = 0.03) and 1.66 (95%CI 1.32-2.09,p < 0.001) respectively for mortality compared to private vehicle transport.
CONCLUSION
Patients with penetrating torso injuries have nearly twice the odds of mortality when transported by ground ambulance than private vehicles, despite injury severity. The "scoop and run" strategy may confer a survival benefit in this population.
背景
院前干预可能会增加获得确定性治疗的时间。与地面救护车相比，我们假设对于通过私人车辆转运的孤立性穿透性躯干损伤患者，死亡率会有所改善。
方法
我们回顾了国家创伤数据库（2017-2021 年），纳入了机制（刺伤 vs. 枪击）和转运模式（私人车辆 vs. 地面救护车）分层的孤立性穿透性躯干损伤的成年人。我们进行了多变量逻辑回归分析，以估计转运模式对死亡率的影响。
结果
48444 名患者符合纳入标准。通过救护车转运的患者，刺伤（n=26633）和枪击（n=21811）的调整后比值比分别为 1.81（95%CI 1.05-3.14，p=0.03）和 1.66（95%CI 1.32-2.09，p<0.001），死亡率高于私人车辆转运。
结论
与私人车辆转运相比，即使损伤严重，通过地面救护车转运的穿透性躯干损伤患者的死亡率也几乎高出两倍。在该人群中，“ scooping and run ”策略可能会带来生存获益。
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