McNicholl B P, Fisher R B, Dearden C H
Accident and Emergency Department, Royal Victoria Hospital, Belfast, UK.
Br J Surg. 1993 Aug;80(8):985-7. doi: 10.1002/bjs.1800800815.
The need for centralized management of acute trauma was evaluated in a 1-year prospective study in Northern Ireland. All patients with an Injury Severity Score > 15 who reached hospital alive were included. The sample population was approximately 1 million people. A total of 239 patients entered the study, of whom 74 died. An audit panel considered that 3-15 per cent of deaths were preventable. There was no significant difference in the preventable mortality rate between any hospital or groups of hospitals. There was a high level of consultant involvement, especially in small hospitals. A system in which patients with acute trauma bypass the nearest hospital to reach a trauma centre may be neither beneficial nor cost-effective in Northern Ireland. Upgrading of the present system with stabilization of the patient and emergency surgery at the nearest hospital before transfer is recommended.
在北爱尔兰进行的一项为期一年的前瞻性研究中，评估了急性创伤集中管理的必要性。纳入了所有损伤严重程度评分>15且存活到达医院的患者。样本人群约为100万人。共有239名患者进入研究，其中74人死亡。一个审核小组认为3% - 15%的死亡是可预防的。任何医院或医院组之间的可预防死亡率没有显著差异。顾问参与程度很高，尤其是在小医院。在北爱尔兰，急性创伤患者绕过最近的医院前往创伤中心的系统可能既无益处也不具有成本效益。建议升级现有系统，在转运前在最近的医院对患者进行稳定治疗和急诊手术。
