Papadimitriou D G, Mathur M N, Hill D A
Royal Prince Alfred Hospital, University of Sydney, Camperdown, New South Wales, Australia.
Aust N Z J Surg. 1994 Jul;64(7):479-83. doi: 10.1111/j.1445-2197.1994.tb02260.x.
This study is a retrospective case series analysis of all 82 road deaths occurring in the Orana Area Health Service (OAHS) over the 2 year period 1989-90. The OAHS services a population of 112,800 in an area of 199,077 km2 in north-west New South Wales. The aim of the study was to document timing, place and cause of deaths, severity of injuries, pre-hospital management of victims, and a TRISS analysis of outcome. This was done using ambulance, hospital, police and autopsy reports. Seventy-two (88%) of the victims were motor vehicle occupants, five (6%) were motorcyclists and four (5%) were pedestrians. The median ambulance response time to the scene of the accident was 17 min (range 2-103 min). All deaths occurred within 24 h of injury with 65 (79%) of the victims being dead at the scene, nine (11%) dying en-route and eight (10%) reaching hospital alive. A TRISS analysis was performed on 51 deaths and 8% (4/51) of these had a greater than 50% probability of survival. Of the victims that had inevitable deaths according to TRISS, 11% (5/47) may have survived if pre-hospital care arrived sooner. Reduction in the rural road toll is achievable through preventative measures and strategies to improve access to care and administration of pre-hospital care.
本研究是对1989 - 1990年两年间奥兰纳地区卫生服务中心(OAHS)发生的82起道路死亡事故进行的回顾性病例系列分析。OAHS为新南威尔士州西北部面积199,077平方公里、人口112,800的地区提供服务。本研究的目的是记录死亡时间、地点和原因、受伤严重程度、受害者的院前处理情况,以及对结果进行创伤和损伤严重程度评分(TRISS)分析。这通过救护车、医院、警方和尸检报告来完成。72名(88%)受害者是机动车驾乘人员,5名(6%)是摩托车手,4名(5%)是行人。救护车对事故现场的中位响应时间为17分钟(范围2 - 103分钟)。所有死亡均发生在受伤后24小时内,65名(79%)受害者在现场死亡,9名(11%)在途中死亡,8名(10%)活着送达医院。对51例死亡进行了TRISS分析,其中8%(4/51)的患者生存概率大于50%。在根据TRISS分析确定为不可避免死亡的受害者中,如果院前护理更早到达,11%(5/47)的人可能存活。通过预防措施以及改善获得护理的机会和院前护理管理的策略,可以降低农村道路伤亡人数。