Damon R T McIntire, Carole S L Spake, Charles C Jehle, Marten N Basta, Joseph W Crozier, Albert S Woo
{"title":"转移过程中的下颌骨骨折很少需要急性干预。","authors":"Damon R T McIntire, Carole S L Spake, Charles C Jehle, Marten N Basta, Joseph W Crozier, Albert S Woo","doi":"10.1177/19433875231161907","DOIUrl":null,"url":null,"abstract":"<p><strong>Study design: </strong>A retrospective review was conducted of all patients with mandibular fractures who were evaluated by plastic surgery at a Level I trauma center between January 1, 2017 and May 1, 2020. Data including demographic characteristics, mechanism of injury, type of presentation (e.g., primary or transfer), treatment plan, and time to intervention were recorded.</p><p><strong>Objective: </strong>Mandibular fractures are common traumatic injuries. Because these injuries are managed by surgical specialists, these patients are often emergently transferred to tertiary care hospitals. This study aims to assess the benefits of emergent transfer in this patient group.</p><p><strong>Methods: </strong>Variables were summarized using descriptive statistics. The relationship with initial disposition was assessed via tests of association, including Student's <i>t</i>-test, Fisher's exact test, or chi-square tests. Significance was set to <i>p</i> values less than 0.05. Multivariate regression analysis was conducted to determine predictors of presentation to outside hospital followed by transfer to our institution.</p><p><strong>Results: </strong>Records from 406 patients with isolated mandibular fractures were evaluated. 145 (36%) were transferred from an outside hospital specifically for specialty evaluation. One patient required intervention in the Emergency Department (ED). Of the 145 patients that were transferred to our facility, eight (5.5%) were admitted for operative management. Patients with open injuries and pediatric patients showed benefit from transfer.</p><p><strong>Conclusions: </strong>Patients are frequently transferred to tertiary care facilities for specialty service evaluation and treatment. However, when isolated mandible fractures were evaluated, only one patient required intervention in the ED. Patients with grossly open fractures and pediatric patients were more frequently admitted specifically for operative management. This practice of acute interfacility transfer represents an unnecessary cost to our health system as isolated mandible fractures can be managed on an outpatient basis. We suggest that pediatric patients and patients with open fractures be transferred for urgent evaluation and management, whereas most patients would be appropriate for outpatient evaluation.</p>","PeriodicalId":50460,"journal":{"name":"Exploration Geophysics","volume":"6 1","pages":"40-46"},"PeriodicalIF":0.6000,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10874203/pdf/","citationCount":"0","resultStr":"{\"title\":\"Mandible Fractures Undergoing Transfer Rarely Require Acute Intervention.\",\"authors\":\"Damon R T McIntire, Carole S L Spake, Charles C Jehle, Marten N Basta, Joseph W Crozier, Albert S Woo\",\"doi\":\"10.1177/19433875231161907\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Study design: </strong>A retrospective review was conducted of all patients with mandibular fractures who were evaluated by plastic surgery at a Level I trauma center between January 1, 2017 and May 1, 2020. Data including demographic characteristics, mechanism of injury, type of presentation (e.g., primary or transfer), treatment plan, and time to intervention were recorded.</p><p><strong>Objective: </strong>Mandibular fractures are common traumatic injuries. Because these injuries are managed by surgical specialists, these patients are often emergently transferred to tertiary care hospitals. This study aims to assess the benefits of emergent transfer in this patient group.</p><p><strong>Methods: </strong>Variables were summarized using descriptive statistics. The relationship with initial disposition was assessed via tests of association, including Student's <i>t</i>-test, Fisher's exact test, or chi-square tests. Significance was set to <i>p</i> values less than 0.05. Multivariate regression analysis was conducted to determine predictors of presentation to outside hospital followed by transfer to our institution.</p><p><strong>Results: </strong>Records from 406 patients with isolated mandibular fractures were evaluated. 145 (36%) were transferred from an outside hospital specifically for specialty evaluation. One patient required intervention in the Emergency Department (ED). Of the 145 patients that were transferred to our facility, eight (5.5%) were admitted for operative management. Patients with open injuries and pediatric patients showed benefit from transfer.</p><p><strong>Conclusions: </strong>Patients are frequently transferred to tertiary care facilities for specialty service evaluation and treatment. However, when isolated mandible fractures were evaluated, only one patient required intervention in the ED. Patients with grossly open fractures and pediatric patients were more frequently admitted specifically for operative management. This practice of acute interfacility transfer represents an unnecessary cost to our health system as isolated mandible fractures can be managed on an outpatient basis. We suggest that pediatric patients and patients with open fractures be transferred for urgent evaluation and management, whereas most patients would be appropriate for outpatient evaluation.</p>\",\"PeriodicalId\":50460,\"journal\":{\"name\":\"Exploration Geophysics\",\"volume\":\"6 1\",\"pages\":\"40-46\"},\"PeriodicalIF\":0.6000,\"publicationDate\":\"2024-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10874203/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Exploration Geophysics\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/19433875231161907\",\"RegionNum\":4,\"RegionCategory\":\"地球科学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/3/1 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"GEOCHEMISTRY & GEOPHYSICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Exploration Geophysics","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/19433875231161907","RegionNum":4,"RegionCategory":"地球科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/3/1 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"GEOCHEMISTRY & GEOPHYSICS","Score":null,"Total":0}
引用次数: 0
摘要
研究设计:对2017年1月1日至2020年5月1日期间在一级创伤中心接受整形外科评估的所有下颌骨骨折患者进行回顾性研究。记录的数据包括人口统计学特征、受伤机制、发病类型(如初诊或转院)、治疗方案和干预时间:下颌骨骨折是常见的外伤。目的:下颌骨骨折是一种常见的外伤,由于这些损伤需要外科专家进行处理,因此这些患者通常会被紧急转送到三级医院。本研究旨在评估紧急转院对这类患者的益处:方法:使用描述性统计对变量进行总结。通过学生 t 检验、费雪精确检验或卡方检验等关联检验来评估与初始处置的关系。显著性设定为 p 值小于 0.05。进行了多变量回归分析,以确定转院到外院的预测因素:对 406 名孤立性下颌骨骨折患者的记录进行了评估。145例(36%)患者是从外院转入本院进行专科评估的。一名患者需要在急诊科(ED)接受治疗。在转入本院的145名患者中,有8名(5.5%)患者入院接受了手术治疗。开放性损伤患者和儿童患者从转院中获益匪浅:结论:患者经常被转送到三级医疗机构接受专科评估和治疗。然而,在对孤立的下颌骨骨折进行评估时,只有一名患者需要在急诊室进行干预。严重开放性骨折患者和儿科患者则更多需要入院接受手术治疗。由于孤立性下颌骨骨折可以在门诊进行治疗,因此这种急性医院间转院的做法给我们的医疗系统带来了不必要的成本。我们建议将小儿患者和开放性骨折患者转院进行紧急评估和治疗,而大多数患者适合在门诊进行评估。
Mandible Fractures Undergoing Transfer Rarely Require Acute Intervention.
Study design: A retrospective review was conducted of all patients with mandibular fractures who were evaluated by plastic surgery at a Level I trauma center between January 1, 2017 and May 1, 2020. Data including demographic characteristics, mechanism of injury, type of presentation (e.g., primary or transfer), treatment plan, and time to intervention were recorded.
Objective: Mandibular fractures are common traumatic injuries. Because these injuries are managed by surgical specialists, these patients are often emergently transferred to tertiary care hospitals. This study aims to assess the benefits of emergent transfer in this patient group.
Methods: Variables were summarized using descriptive statistics. The relationship with initial disposition was assessed via tests of association, including Student's t-test, Fisher's exact test, or chi-square tests. Significance was set to p values less than 0.05. Multivariate regression analysis was conducted to determine predictors of presentation to outside hospital followed by transfer to our institution.
Results: Records from 406 patients with isolated mandibular fractures were evaluated. 145 (36%) were transferred from an outside hospital specifically for specialty evaluation. One patient required intervention in the Emergency Department (ED). Of the 145 patients that were transferred to our facility, eight (5.5%) were admitted for operative management. Patients with open injuries and pediatric patients showed benefit from transfer.
Conclusions: Patients are frequently transferred to tertiary care facilities for specialty service evaluation and treatment. However, when isolated mandible fractures were evaluated, only one patient required intervention in the ED. Patients with grossly open fractures and pediatric patients were more frequently admitted specifically for operative management. This practice of acute interfacility transfer represents an unnecessary cost to our health system as isolated mandible fractures can be managed on an outpatient basis. We suggest that pediatric patients and patients with open fractures be transferred for urgent evaluation and management, whereas most patients would be appropriate for outpatient evaluation.
期刊介绍:
Exploration Geophysics is published on behalf of the Australian Society of Exploration Geophysicists (ASEG), Society of Exploration Geophysics of Japan (SEGJ), and Korean Society of Earth and Exploration Geophysicists (KSEG).
The journal presents significant case histories, advances in data interpretation, and theoretical developments resulting from original research in exploration and applied geophysics. Papers that may have implications for field practice in Australia, even if they report work from other continents, will be welcome. ´Exploration and applied geophysics´ will be interpreted broadly by the editors, so that geotechnical and environmental studies are by no means precluded.
Papers are expected to be of a high standard. Exploration Geophysics uses an international pool of reviewers drawn from industry and academic authorities as selected by the editorial panel.
The journal provides a common meeting ground for geophysicists active in either field studies or basic research.