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美国创伤中心中警察转运与地面救护车转运钝性创伤患者的结局。

Outcomes of blunt trauma patients in police versus ground ambulance transport across US trauma centers.

作者信息

Rahhal Romy, Sakr Paul, Bachir Rana, El Sayed Mazen

机构信息

Department of Emergency Medicine Northeast Georgia Medical Center Gainesville Georgia USA.

Faculty of Medicine University of Balamand El-Koura Lebanon.

出版信息

Acute Med Surg. 2025 May 8;12(1):e70061. doi: 10.1002/ams2.70061. eCollection 2025 Jan-Dec.


DOI:10.1002/ams2.70061
PMID:40353044
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12061841/
Abstract

AIM: Blunt injuries constitute a major cause of death in the United States. Regionalization in trauma systems improves patients' survival and outcomes. Limited data exist on the impact of mode of transport in regionalized trauma systems. This study examines the association between trauma designation levels and survival to hospital discharge of patients with blunt trauma transported by police or ground ambulance. METHODS: This retrospective-matched cohort study used the 2017 National Trauma Data Bank dataset. Adult blunt trauma patients transported by police were identified and matched (one-to-four) to those transported by ground ambulance. Demographic characteristics, injury, and clinical data were described and compared according to trauma designation levels. The survival rate was determined by the transport mode and/or the trauma designation levels. RESULTS: A total of 5316 blunt trauma patients were included. Mean age was 41.8 (±16.5) years, and most were males (81.8%). Most patients were transported to Level I centers and were more likely to be admitted (91.1%) compared to those transported to level II and level III trauma centers (87.5%). They also had a lower survival rate compared with the latter group ((98.7%) vs. (99.7%),  = 0.001). Survival rates were similar when comparing patients by mode of transport ( = 0.785). This remained unchanged after stratifying by the trauma designation levels ( > 0.05). CONCLUSIONS: Adult patients with blunt trauma transported by police or ground ambulance had similar survival across different trauma level centers. Increased police involvement in the transport of blunt trauma patients is recommended.

摘要

目的:钝性损伤是美国主要的死亡原因之一。创伤系统的区域化可提高患者的生存率和治疗效果。关于区域化创伤系统中运输方式的影响,现有数据有限。本研究探讨创伤指定级别与由警察或地面救护车运送的钝性创伤患者出院生存率之间的关联。 方法:这项回顾性匹配队列研究使用了2017年国家创伤数据库数据集。确定由警察运送的成年钝性创伤患者,并与由地面救护车运送的患者进行(一对一至四)匹配。根据创伤指定级别描述并比较人口统计学特征、损伤情况和临床数据。通过运输方式和/或创伤指定级别确定生存率。 结果:共纳入5316例钝性创伤患者。平均年龄为41.8(±16.5)岁,大多数为男性(81.8%)。大多数患者被送往一级中心,与送往二级和三级创伤中心的患者相比,更有可能被收治(91.1%)。与后一组相比,他们的生存率也较低((98.7%)对(99.7%),P = 0.001)。按运输方式比较患者时,生存率相似(P = 0.785)。按创伤指定级别分层后,这一情况保持不变(P>0.05)。 结论:由警察或地面救护车运送的成年钝性创伤患者在不同创伤级别中心的生存率相似。建议增加警察参与钝性创伤患者的运输。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09cc/12061841/b68bc59b5f7b/AMS2-12-e70061-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09cc/12061841/b68bc59b5f7b/AMS2-12-e70061-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/09cc/12061841/b68bc59b5f7b/AMS2-12-e70061-g001.jpg

相似文献

[1]
Outcomes of blunt trauma patients in police versus ground ambulance transport across US trauma centers.

Acute Med Surg. 2025-5-8

[2]
Association between Mode of Transportation and Survival in Adult Trauma Patients with Blunt Injuries: Matched Cohort Study between Police and Ground Ambulance Transport.

Prehosp Disaster Med. 2021-8

[3]
Association between Mode of Transportation and Survival in Adult Trauma Patients with Penetrating Injuries: Matched Cohort Study between Police and Ground Ambulance Transport.

Prehosp Disaster Med. 2022-3-8

[4]
Impact of Trauma Center Designation Level on the Survival of Trauma Patients Transported by Police in the United States.

Prehosp Emerg Care. 2022

[5]
Association between helicopter vs ground emergency medical services and survival for adults with major trauma.

JAMA. 2012-4-18

[6]
Impact of trauma level designation on survival of patients arriving with no signs of life to US trauma centers.

Am J Emerg Med. 2019-8-6

[7]
Patient Characteristics and Temporal Trends in Police Transport of Blunt Trauma Patients: A Multicenter Retrospective Cohort Study.

Prehosp Emerg Care. 2017-6-29

[8]
Association of Police Transport With Survival Among Patients With Penetrating Trauma in Philadelphia, Pennsylvania.

JAMA Netw Open. 2021-1-4

[9]
Police transport versus ground EMS: A trauma system-level evaluation of prehospital care policies and their effect on clinical outcomes.

J Trauma Acute Care Surg. 2016-11

[10]
Association Between Mode of Transportation and Outcomes of Adult Trauma Patients With Blunt Injury Across Different Prehospital Time Intervals in the United States: A Matched Cohort Study.

J Emerg Med. 2020-12

本文引用的文献

[1]
How do current police practices impact trauma care in the prehospital setting? A scoping review.

J Am Coll Emerg Physicians Open. 2023-5-23

[2]
Impact of Trauma Center Designation Level on the Survival of Trauma Patients Transported by Police in the United States.

Prehosp Emerg Care. 2022

[3]
Association between Mode of Transportation and Survival in Adult Trauma Patients with Blunt Injuries: Matched Cohort Study between Police and Ground Ambulance Transport.

Prehosp Disaster Med. 2021-8

[4]
Trauma Center Outcomes After Transition From Level 2 to Level 1: A National Trauma Data Bank Analysis.

J Surg Res. 2021-8

[5]
Beyond survival: the broader consequences of prehospital transport by police for penetrating trauma.

Trauma Surg Acute Care Open. 2020-11-26

[6]
Factors Associated with Survival in Adult Trauma Patients Transported to US Trauma Centers by Police.

Prehosp Disaster Med. 2021-2

[7]
Association between prehospital time and outcome of trauma patients in 4 Asian countries: A cross-national, multicenter cohort study.

PLoS Med. 2020-10-6

[8]
The Effect of Trauma Center Verification Level on Outcomes in Traumatic Brain Injury Patients Undergoing Interfacility Transfer.

Acad Emerg Med. 2021-3

[9]
Association Between Trauma Center Level and Outcomes of Adult Patients with Motorcycle Crash-Related Injuries in the United States.

J Emerg Med. 2020-10

[10]
Association of Trauma Center Level and Patient Volume with Outcomes for Penetrating Thoracic Trauma.

J Surg Res. 2020-6-30

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