Visingardi Joseph, Feustel Paul J, Edwards Kurt, Inouye Brian, Welliver Charles
Albany Medical College, Albany, NY, USA.
Neuroscience and Experimental Therapeutics, Albany Medical College, Albany, NY, USA.
Eur J Trauma Emerg Surg. 2025 Jan 24;51(1):38. doi: 10.1007/s00068-024-02674-w.
Trauma patients frequently may be transported significant distance to receive care at a level one trauma center. Increasing distance may cause delays in care. We sought to investigate whether distance traveled for level 1 trauma care affected rates of intervention for renal trauma.
We queried our institutions reportable trauma database from the years 2015 to 2022. This data was filtered for all patients that had ICD codes pertaining to renal trauma. All renal trauma patients with zip codes where they sustained their injury were included. We then calculated the distance traveled to our hospital via Google Maps for each patient. We aggregated diagnosis codes for percutaneous angioembolism and nephrectomy. Injury severity scores (ISS) were collected. We divided patients into two groups based on distance traveled (0-30 miles and 31 + miles). We also analyzed the number of angioembolizations and open renal surgery completed for each mile distance category and analyzed for a difference between the groups.
Our database yielded 307 cases of renal trauma that met inclusion criteria. We found no difference in rates of percutaneous angioembolism and open renal surgery between patients that traveled different distances for renal trauma care.
Few studies have assessed distance traveled for trauma care and need for intervention. Our findings that an increased travel distance did not lead to a significantly increased risk for intervention are reassuring. Based on these findings, distance traveled for appropriate trauma care may not be a factor when deciding on transfers for renal trauma.
创伤患者常常需要被转运到较远的距离，以便在一级创伤中心接受治疗。距离增加可能会导致治疗延迟。我们试图研究前往一级创伤中心接受肾脏创伤治疗所行驶的距离是否会影响肾脏创伤的干预率。
我们查询了本机构2015年至2022年可报告的创伤数据库。对所有具有与肾脏创伤相关ICD编码的患者数据进行筛选。纳入所有受伤时邮政编码已知的肾脏创伤患者。然后，我们通过谷歌地图计算每位患者前往我院的距离。汇总经皮血管栓塞术和肾切除术的诊断编码。收集损伤严重程度评分（ISS）。根据行驶距离将患者分为两组（0 - 30英里和31英里以上）。我们还分析了每个英里距离类别完成的血管栓塞术和开放性肾脏手术的数量，并分析两组之间的差异。
我们的数据库产生了307例符合纳入标准的肾脏创伤病例。我们发现，因肾脏创伤治疗而行驶不同距离的患者之间，经皮血管栓塞术和开放性肾脏手术的发生率没有差异。
很少有研究评估创伤治疗的行驶距离和干预需求。我们的研究结果表明，行驶距离增加并不会导致干预风险显著增加，这令人安心。基于这些发现，在决定肾脏创伤患者的转运时，前往合适创伤中心的行驶距离可能不是一个考虑因素。
