Hospital Mortality Based on the Mode of Emergency Medical Services Transportation.
Hospital Mortality Based on the Mode of Emergency Medical Services Transportation.
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DOI：
10.1016/j.amj.2017.03.003
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发表时间：
2017-07-01
影响因子：
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通讯作者：
Consunji, Rafael
中科院分区：
文献类型：
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作者：
Al-Thani, Hassan;El-Menyar, Ayman;Consunji, Rafael
目的：我们评估了直升机紧急医疗服务（HEMS）与地面紧急医疗服务（GEMS）运送的创伤患者的介绍和结局。方法：对2011年至2013年期间由GEMS和HEMS运送的患者在I级创伤中心进行创伤登记数据的回顾性分析。结果：共收治创伤患者4,596例，平均年龄（31 ± 15）岁。受伤的病人被送往创伤中心的GEMS（93.3%）和HEMS（6.7%）。常见的损伤机制是机动车碰撞（37%）和福尔斯（25%）。与GEMS相比，HEMS转运的患者具有更大的损伤严重度，更大比例的创伤性脑损伤，现场插管和2.5倍的死亡率。然而，运输方式对严重受伤患者的住院死亡率的影响在调整潜在的混杂因素后已经消失。结论：HEMS运输的患者与GEMS相比可能具有不同的特征和结局。然而，需要进一步的工作，以确定谁明显受益于使用HEMS的创伤患者的亚组。
OBJECTIVE: We assessed the presentations and outcomes of trauma patients transported by helicopter emergency medical services (HEMS) versus ground emergency medical services (GEMS).METHODS: A retrospective analysis of trauma registry data at a level I trauma center was conducted for patients transported by GEMS and HEMS between 2011 and 2013. Data were analyzed and categorized based on the mode of transportation.RESULTS: A total of 4,596 trauma patients were admitted to the hospital with a mean age of 31 ± 15 years. Injured patients were transported to the trauma center by GEMS (93.3%) and HEMS (6.7%). The common mechanisms of injury were motor vehicle crash (37%) and falls (25%). Compared with GEMS, patients transported by HEMS were characterized by having a greater injury severity, more proportion of traumatic brain injury, on-scene intubation, and a 2.5-fold higher mortality. However, the impact of mode of transportation on the hospital mortality among severely injured patients has disappeared after adjusting for potential confounders.CONCLUSION: Patients transported by HEMS may have different characteristic features and outcomes when compared with GEMS. However, further work is needed to identify the subgroups of trauma patients who clearly benefit from the use of HEMS.