[国家创伤中心差别化复苏室激活分析]。

Unfallchirurgie (Heidelberg, Germany) Pub Date : 2024-04-01 Epub Date: 2023-11-20 DOI:10.1007/s00113-023-01391-0
Jonas Limmer, Mila M Paul, Martin Kraus, Hendrik Jansen, Thomas Wurmb, Maximilian Kippnich, Daniel Röder, Patrick Meybohm, Rainer H Meffert, Martin C Jordan
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引用次数: 0

摘要

背景:为了继续有效地为重症伤员提供人员密集型和资源密集型的护理,一些医院对复苏室的治疗实行了个性化的区分制度。本研究的目的是在巴伐利亚州的国家创伤中心评估A和B分类的实用性、适应症和潜在并发症的概念。方法:通过回顾性研究,收集2020年复苏室创伤患者的数据。A和B的分配是由院前急诊医师下达的。记录损伤严重程度评分(ISS)、格拉斯哥结局量表(GOS)、升级率及根据S3指南的适应证标准等参数。统计资料比较采用t检验、χ2检验或Mann-Whitney U检验。结果:879例复苏室治疗(A 473例,B 406例)符合纳入标准。结果发现,94.5%的复苏室A病例有医生陪同,而复苏室B的这一比例为48%。除了ISS评分显著降低(4.1比13.9)外,29.8%的B组患者不符合S3指南中定义的治疗标准。升级率低,仅4.9%,98%的B组患者GOS评分为4或5分。结论:所提出的分类方法是一种有效、安全的方法,可以优化资源,管理日益增多的复苏室警报。
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[Analysis of a differentiated resuscitation room activation at a national trauma center].

Background: In order to continue to efficiently provide both personnel-intensive and resource-intensive care to severely injured patients, some hospitals have introduced individually differentiated systems for resuscitation room treatment. The aim of this study was to evaluate the concept of the A and B classifications in terms of practicability, indications, and potential complications at a national trauma center in Bavaria.

Methods: In a retrospective study, data from resuscitation room trauma patients in the year 2020 were collected. The assignment to A and B was made by the prehospital emergency physician. Parameters such as the injury severity score (ISS), Glasgow outcome scale (GOS), upgrade rate, and the indication criteria according to the S3 guidelines were recorded. Statistical data comparisons were made using t‑tests, χ2-tests, or Mann-Whitney U‑tests.

Results: A total of 879 resuscitation room treatments (A 473, B 406) met the inclusion criteria. It was found that 94.5% of resuscitation room A cases had physician accompaniment, compared to 48% in resuscitation room B assignments. In addition to significantly lower ISS scores (4.1 vs. 13.9), 29.8% of B patients did not meet the treatment criteria defined in the S3 guidelines. With a low upgrade rate of 4.9%, 98% of B patients had a GOS score of 4 or 5.

Conclusion: The presented categorization is an effective and safe way to manage the increasing number of resuscitation room alerts in a resource-optimized manner.

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