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基于国家急诊科信息系统数据的韩国仁川广域市穿透性创伤患者的流行病学及转归:一项回顾性队列研究

Epidemiology and outcomes of patients with penetrating trauma in Incheon Metropolitan City, Korea based on National Emergency Department Information System data: a retrsopective cohort study.

作者信息

Kim Youngmin, Yu Byungchul, Jeon Se-Beom, Lee Seung Hwan, Cho Jayun, Gwak Jihun, Park Youngeun, Choi Kang Kook, Lee Min A, Lee Gil Jae, Lee Jungnam

机构信息

Department of Trauma Surgery, Gachon University Gil Medical Center, Incheon, Korea.

Department of Traumatology, Gachon University College of Medicine, Incheon, Korea.

出版信息

J Trauma Inj. 2023 Sep;36(3):224-230. doi: 10.20408/jti.2022.0055. Epub 2022 Dec 21.

Abstract

PURPOSE

Patients with penetrating injuries are at a high risk of mortality, and many of them require emergency surgery. Proper triage and transfer of the patient to the emergency department (ED), where immediate definitive treatment is available, is key to improving survival. This study aimed to evaluate the epidemiology and outcomes of patients with penetrating torso injuries in Incheon Metropolitan City.

METHODS

Data from trauma patients between 2014 and 2018 (5 years) were extracted from the National Emergency Department Information System. In this study, patients with penetrating injuries to the torso (chest and abdomen) were selected, while those with superficial injuries were excluded.

RESULTS

Of 66,285 patients with penetrating trauma, 752 with injuries to the torso were enrolled in this study. In the study population, 345 patients (45.9%) were admitted to the ward or intensive care unit (ICU), 20 (2.7%) were transferred to other hospitals, and 10 (1.3%) died in the ED. Among the admitted patients, 173 (50.1%) underwent nonoperative management and 172 (49.9%) underwent operative management. There were no deaths in the nonoperative management group, but 10 patients (5.8%) died after operative management. The transferred patients showed a significantly longer time from injury to ED arrival, percentage of ICU admissions, and mortality. There were also significant differences in the percentage of operative management, ICU admissions, ED stay time, and mortality between hospitals.

CONCLUSIONS

Proper triage guidelines need to be implemented so that patients with torso penetrating trauma in Incheon can be transferred directly to the regional trauma center for definitive treatment.

摘要

目的

穿透伤患者死亡率高,其中许多人需要紧急手术。将患者正确分诊并转运至能立即进行确定性治疗的急诊科是提高生存率的关键。本研究旨在评估仁川广域市穿透性躯干伤患者的流行病学特征及治疗结果。

方法

从国家急诊科信息系统中提取2014年至2018年(5年)创伤患者的数据。本研究选取了躯干(胸部和腹部)穿透伤患者,排除了表浅伤患者。

结果

在66285例穿透伤患者中,752例躯干伤患者纳入本研究。在研究人群中,345例患者(45.9%)入住病房或重症监护病房(ICU),20例(2.7%)转至其他医院,10例(1.3%)在急诊科死亡。在入院患者中,173例(50.1%)接受了非手术治疗,172例(49.9%)接受了手术治疗。非手术治疗组无死亡病例,但手术治疗后有10例患者(5.8%)死亡。转院患者从受伤到抵达急诊科的时间、入住ICU的比例和死亡率明显更长。不同医院之间在手术治疗比例、入住ICU比例、急诊科停留时间和死亡率方面也存在显著差异。

结论

需要实施适当的分诊指南,以便仁川的躯干穿透伤患者能够直接转至区域创伤中心进行确定性治疗。

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