Reduced population burden of road transport-related major trauma after introduction of an inclusive trauma system.
Reduced population burden of road transport-related major trauma after introduction of an inclusive trauma system.
复制标题
DOI：
10.1097/sla.0000000000000522
复制
发表时间：
2015-03
影响因子：
9
通讯作者：
Cameron PA
中科院分区：
文献类型：
--
作者：
Gabbe BJ;Lyons RA;Fitzgerald MC;Judson R;Richardson J;Cameron PA
这项以人口为基础的研究发现，自从澳大利亚维多利亚州引入包容性、区域化的创伤系统以来，与道路运输相关的严重伤害的负担已经减少。住院的重大创伤病例增加，但每例伤残负担下降。存活率的增加并不会导致非致命性伤害负担的总体增加。描述引入综合创伤系统后，澳大利亚维多利亚州10年来与公路运输相关的严重伤害的负担。道路交通伤害是世界范围内死亡和残疾的主要原因。努力改善对伤者的护理对于减轻负担很重要，但创伤护理系统对道路交通伤害的负担和成本的影响尚未得到评估。所有与道路运输有关的死亡和重大创伤(伤害严重程度评分12)病例都是从2001年7月至2011年6月基于人口的验尸官和创伤登记数据集中提取的。模型被用来评估人群发病率和住院死亡率的变化。计算了伤残调整寿命年，包括减寿年数和残废寿命年数。健康损失成本是根据伤残调整生命年的估计价值计算出来的。与道路运输相关的死亡发生率下降(发生率比0.95，95%可信区间：0.94-0.96)，而住院严重创伤发生率增加(发生率比1.03，95%可信区间：1.02-1.04)。减寿年数减少了43%，残废寿命增加了32%，十年间经伤残调整的寿命年数总体减少了28%。与2001-2002财政年度相比，2010-2011年每宗个案节省的费用为633,446澳元。自澳大利亚维多利亚州引入创伤系统以来，与道路运输相关的严重伤害的负担有所减少。住院的重大创伤病例增加，而每个病例的残疾负担下降。存活率的增加并不一定会导致非致命性伤害负担的总体增加。
This population-based study found that since the introduction of an inclusive, regionalized trauma system in Victoria, Australia, the burden of road transport–related serious injury has decreased. Hospitalized major trauma cases increased, but disability burden per case declined. Increased survival did not result in an overall increase in nonfatal injury burden. To describe the burden of road transport–related serious injury in Victoria, Australia, over a 10-year period, after the introduction of an integrated trauma system. Road traffic injury is a leading cause of death and disability worldwide. Efforts to improve care of the injured are important for reducing burden, but the impact of trauma care systems on burden and cost of road traffic injury has not been evaluated. All road transport–related deaths and major trauma (injury severity score >12) cases were extracted from population-based coroner and trauma registry data sets for July 2001 to June 2011. Modeling was used to assess changes in population incidence rates and odds of in-hospital mortality. Disability-adjusted life years, combining years of life lost and years lived with disability, were calculated. Cost of health loss was calculated from estimates of the value of a disability-adjusted life year. Incidence of road transport–related deaths decreased (incidence rate ratio 0.95, 95% confidence interval: 0.94–0.96), whereas the incidence of hospitalized major trauma increased (incidence rate ratio 1.03, 95% confidence interval: 1.02–1.04). Years of life lost decreased by 43%, and years lived with disability increased by 32%, with an overall 28% reduction in disability-adjusted life years over the decade. There was a cost saving per case of A$633,446 in 2010–2011 compared with the 2001–2002 financial year. Since introduction of the trauma system in Victoria, Australia, the burden of road transport–related serious injury has decreased. Hospitalized major trauma cases increased, whereas disability burden per case declined. Increased survival does not necessarily result in an overall increase in nonfatal injury burden.