Assessing effectiveness of a mature trauma system: Association of trauma center presence with lower injury mortality rate
Assessing effectiveness of a mature trauma system: Association of trauma center presence with lower injury mortality rate
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DOI：
10.1097/01.ta.0000221789.53864.ba
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发表时间：
2006-08-01
影响因子：
--
通讯作者：
Flint, Lewis
中科院分区：
文献类型：
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作者：
Papa, Linda;Langland-Orban, Barbara;Flint, Lewis
Objective.通过比较有创伤中心（TC）和没有创伤中心（NTC）的县的机动车碰撞（MVC）死亡率，确定创伤中心护理在成熟创伤系统中的有效性。分析了2003年发生的MVCs的状态数据。将TC县的车祸死亡人数与NTC县进行了比较。主要结局是病死率，次要结局是车祸死亡率。来自67个佛罗里达县和20个TC的数据进行了评估。协变量，如年龄，速度，酒精使用，院前资源，农村/城市的位置进行了调整的分析。2003年，全州WC死亡率为18.6/100，000。总体国家病死率为2.8%（95% CI = 2.4-3.3）。有13个TC县的平均死亡率为17.7/100，000（95%CI = 14.5-20.9），54个NTC县的平均死亡率为33.4/100，000（95%CI = 28.8-38.0; p < 0.001）。TC县病死率为1.4%（95%CI = 1.1-1.7），NTC县病死率为3.2%（95%CI = 2.7-3.7）（P < 0.001）。TC县和NTC县的车祸死亡率分别为1.4%（95%CI = 1.0-1.8）和3.3%（95%CI = 2.8-3.7）（p < 0.001）。TC县的WC死亡率显著低于NTC县。这种关联是独立的年龄，饮酒，速度，农村/城市的位置，和院前资源。
Objective. To determine effectiveness of trauma center care in a mature trauma system by comparing motor vehicle crash (MVC) death rates in counties with a trauma center (TC) to those without a trauma center (NTC).Methods. State data for MVCs occurring in 2003 were analyzed. Fatalities from crashes in counties with a TC were compared with NTC counties. The primary outcome was case-fatality rate and the secondary outcome was crash-fatality rate. Data from 67 Florida counties and 20 TCs were assessed. Covariates such as age, speed, alcohol use, prehospital resources, and rural/urban location were adjusted for in the analysis.Results. The statewide incidence of fatality from WC in 2003 was 18.6 per 100,000. The overall state case-fatality rate was 2.8% (95% CI = 2.4-3.3). There were 13 TC counties with a mean fatality rate of 17.7 per 100,000 (95% CI = 14.5-20.9) and 54 NTC counties with a mean fatality rate 33.4 per 100,000 (95% CI = 28.8-38.0; p < 0.001). The case-fatality rate was 1.4% (95% CI = 1.1-1.7) in TC counties and 3.2% (95 % CI = 2.7-3.7) in NTC counties (p < 0.001). Moreover, crash-fatality rate in TC counties and NTC counties was 1.4% (95% CI = 1.0-1.8) versus 3.3% (95% CI = 2.8-3.7) respectively (p < 0.001).Conclusions.. TC counties had significantly lower WC death rates than NTC counties. This association was independent of age, alcohol use, speed, rural/urban location, and prehospital resources.