Jang Myung Jin, Choi Woo Sung, Lee Jung Nam, Park Won Bin
Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea.
Department of Emergency Medicine, Gachon University Gil Medical Center, Incheon, Korea.
J Trauma Inj. 2024 Jun;37(2):106-113. doi: 10.20408/jti.2023.0074. Epub 2024 Feb 23.
Helicopter transport with medical teams has been proven to be effective, with improvements in patient survival rates. This study compared and analyzed the clinical characteristics and treatment outcomes of trauma patients transported by doctor helicopters according to whether patients were transferred after a clinical evaluation or without a clinical evaluation.
This study retrospectively reviewed data from the Korean Trauma Data Bank of trauma patients who arrived at a regional trauma center through doctor helicopters from January 1, 2014, to December 31, 2022. The patients were divided into two groups: doctor helicopter transport before evaluation (DHTBE) and doctor helicopter transport after evaluation (DHTAE). These groups were compared.
The study population included 351 cases. At the time of arrival at the trauma center, the systolic blood pressure was significantly lower in the DHTAE group than in the DHTBE group (P=0.018). The Injury Severity Score was significantly higher in the DHTAE group (P<0.001), and the accident to trauma center arrival time was significantly shorter in the DHTBE group (P<0.001). Mortality did not show a statistically significant between-group difference (P=0.094). Surgical cases in the DHTAE group had a longer time from the accident scene to trauma center arrival (P=0.002). The time from the accident to the operation room or from the accident to angioembolization showed no statistically significant differences.
DHTAE was associated with significantly longer transport times to the trauma center, as well as nonstatistically significant trends for delays in receiving surgery and procedures, as well as higher mortality. If severe trauma is suspected, air transport to a trauma center should be requested immediately after a simple screening test (e.g., mechanism of injury, Glasgow Coma Scale, or Focused Assessment with Sonography in Trauma), which may help reduce the time to definitive treatment.
事实证明,配备医疗团队的直升机转运是有效的,可提高患者生存率。本研究根据创伤患者在临床评估后或未进行临床评估就被转运的情况,对比分析了由医生直升机转运的创伤患者的临床特征和治疗结果。
本研究回顾性分析了2014年1月1日至2022年12月31日通过医生直升机抵达地区创伤中心的创伤患者的韩国创伤数据库数据。患者分为两组:评估前医生直升机转运组(DHTBE)和评估后医生直升机转运组(DHTAE)。对这两组进行比较。
研究人群包括351例病例。到达创伤中心时,DHTAE组的收缩压显著低于DHTBE组(P = 0.018)。DHTAE组的损伤严重程度评分显著更高(P < 0.001),而DHTBE组从事故到创伤中心到达的时间显著更短(P < 0.001)。死亡率在组间差异无统计学意义(P = 0.094)。DHTAE组的手术病例从事故现场到创伤中心到达的时间更长(P = 0.002)。从事故到手术室或从事故到血管栓塞的时间差异无统计学意义。
DHTAE与到创伤中心的转运时间显著延长相关,以及在接受手术和治疗方面有延迟的非统计学显著趋势,以及更高的死亡率。如果怀疑是严重创伤,在进行简单筛查测试(例如,损伤机制、格拉斯哥昏迷量表或创伤重点超声评估)后应立即请求空运至创伤中心,这可能有助于减少确定性治疗的时间。