Advanced or basic life support for trauma: Meta-analysis and critical review of the literature
Advanced or basic life support for trauma: Meta-analysis and critical review of the literature
复制标题
DOI：
10.1097/00005373-200010000-00003
复制
发表时间：
2000-10-01
影响因子：
--
通讯作者：
Sampalis, J
中科院分区：
文献类型：
--
作者：
Liberman, M;Mulder, D;Sampalis, J
背景：对于院前创伤患者是否使用高级生命支持（ALS）或基本生命支持（BLS）的问题一直存在很多争论，但仍然缺乏明确的答案。本研究的目的是对有关这一争议的文献进行全面的批判性回顾。方法：共回顾了 174 篇关于院前 ALS 或 BLS 治疗创伤的文章。其中 15 项研究涉及 ALS 和 BLS 治疗患者的死亡率统计数据。计算了 ALS 与 BLS 的生存比值比，并根据结合了设计和方法评估的多变量评分系统对研究进行了总结。所有研究的总体比值比都是根据论文中的原始数据计算的，加权比值比是根据评分系统计算的。结果：六项研究在方法学上得分为平均（5项支持BLS，1项支持ALS），两项研究评分为良好（1项支持BLS，1项支持ALS），七项研究为优秀（6项支持BLS，1项支持ALS），十项研究的研究设计得分为平均（6项支持BLS，1项支持ALS）。 4 名赞成 ALS）和 7 名具有良好的研究设计得分（6 名赞成 BLS，1 名赞成 ALS），与接受 BLS 的患者相比，接受 ALS 的患者死亡的加权比值比为 2.59，粗比值比为 2.92。结论：文献中的汇总数据未能证明为创伤患者提供现场 ALS 的益处并支持舀和运行方法。
Background: The question of whether to use advanced life support (ALS) or basic life support (BLS) for trauma patients in the prehospital setting has been much debated and still lacks a clear answer. The purpose of this study was to conduct a comprehensive critical review of the literature regarding this controversyMethods: A total of 174 articles on prehospital ALS or BLS for trauma were reviewed. Fifteen of these studies were found to involve mortality statistics for both ALS- and BLS-treated patients. Odds ratios were calculated for survival in ALS versus BLS and summarized across studies on the basis of multivariate scoring systems that incorporated both design and methodological assessment. Overall odds ratios for all studies were calculated on the basis of both raw data from the papers, and weighted odds ratios were calculated from the scoring systems.Results: Six studies were scored as being methodologically average (5 favoring BLS and 1 favoring ALS), two were scored as good (1 favoring BLS and 1 favoring ALS), seven as excellent (6 favoring BLS and 1 favoring ALS), Ten studies had an average study design score (6 favoring BLS and 4 favoring ALS) and seven had a good study design score (6 favoring BLS and 1 favoring ALS), Weighted odds ratio for dying was 2.59 for patients receiving ALS compared with those receiving BLS, The crude odds ratio was 2.92.Conclusion: The aggregated data in the literature have failed to demonstrate a benefit for on-site ALS provided to trauma patients and support the scoop and run approach.