Petrie D, Lane P, Stewart T C
Department of Emergency Medicine, London Health Sciences Centre, University of Western Ontario, Canada.
J Trauma. 1996 Nov;41(5):870-3; discussion 873-5. doi: 10.1097/00005373-199611000-00020.
The purpose of this study was to compare the outcomes of trauma patients with an Injury Severity Score (ISS) > 12 who had the trauma team involved (TTA) in their resuscitative care to those that did not (TTNA).
Level I regional trauma center teaching hospital with university affiliation.
All trauma patients admitted between July 1, 1991 and August 31, 1994 with an ISS > 12 were identified through the trauma registry. Burn patients, those who suffered their injury > 24 hours before admission, and deaths in the emergency room were excluded from analysis. The TRISS methodology, which offers a standard approval for evaluating outcomes for different populations of trauma patients, was used to determine whether there was a difference in outcomes between the two groups. To include patients who arrived at the trauma center intubated, a Trauma and Injury Severity Score (TRISS)-like analysis was also conducted on this patient population.
A total of 640 patients were identified; 174 (65.2%) in the TTA group and 223 (34.8%) in the TTNA group. A total of 448 (70%) were eligible for TRISS analysis and 574 (89.7%) were eligible for TRISS-like analysis. Using the TRISS analysis, the TTA group had a Z statistic of 3.36 yielding a W score of 4.27. This compared to the TTNA group whose Z statistic was 0.30. Using the TRISS-like logistic regression equation, the TTA group had a Z statistic of 6.50, yielding a W score of 8.60 compared with the TTNA group whose Z statistic was 0.88. After controlling for differences in the demographics of the two groups, the TTA still had consistently higher Z scores.
In a Level I trauma center, the outcomes of trauma patients with an ISS > 12 are statistically significantly better if the trauma team is activated than if the patients are managed on an individual service-by-service basis.
本研究旨在比较损伤严重度评分（ISS）>12且复苏治疗中有创伤团队参与（TTA）的创伤患者与无创伤团队参与（TTNA）的创伤患者的治疗结果。
隶属于大学的一级区域创伤中心教学医院。
通过创伤登记系统识别出1991年7月1日至1994年8月31日期间收治的所有ISS>12的创伤患者。烧伤患者、入院前受伤超过24小时的患者以及在急诊室死亡的患者被排除在分析之外。采用创伤和损伤严重度评分（TRISS）方法（该方法为评估不同创伤患者群体的治疗结果提供了标准认可）来确定两组患者的治疗结果是否存在差异。为纳入到达创伤中心时已插管的患者，还对该患者群体进行了类似TRISS的分析。
共识别出640例患者；TTA组174例（65.2%），TTNA组223例（34.8%）。共有448例（70%）符合TRISS分析条件，574例（89.7%）符合类似TRISS分析条件。使用TRISS分析，TTA组的Z统计量为3.36，W评分为4.27。相比之下，TTNA组的Z统计量为0.30。使用类似TRISS的逻辑回归方程，TTA组的Z统计量为6.50，W评分为8.60，而TTNA组的Z统计量为0.88。在控制两组人口统计学差异后，TTA组的Z评分仍始终较高。
在一级创伤中心，ISS>12的创伤患者在激活创伤团队时的治疗结果在统计学上显著优于逐个科室单独治疗的结果。
