Direct transport to tertiary trauma centers versus transfer from lower level facilities : Impact on mortality and morbidity among patients with major trauma. Discussion.
Annual Meeting of the American Association for the Surgery of Trauma. Houston (USA), 1996/09/19.
The purpose of the study was to compare the outcome of severely injured patients who were transported directly to a Level I, tertiary trauma center with those who were transferred after being first transported to less specialized hospitals.
The data were based on all patients treated at three tertiary trauma centers in Quebec between April 1,1993, and December 31,1995.
There were 1,608 patients (37%) transferred and 2,756 patients (63%) transported directly.
The mean age of the patients was approximately 45 years, and more than 60% were males.
The predominant mechanisms of injury were falls and motor vehicle crashes.
The transfer and direct transport groups were similar with respect to age, gender, and mechanism of injury.
Body regions injured were also similar with the exception of head or neck injuries (transfer, 56% ; direct, 28% ; p<0.0001).
The mean Injury Severity Score was 14, the mean Pre-Hospital Index score was 5.5, and the mean Revised Trauma Score was 7.5. The two groups were similar with respect to these injury severity measures.
The primary outcome of interest was mortality described as overall death rate, death rate in the emergency room, and death rate after admission.
Other outcomes studied were hospital length of stay and duration of treatment in an intensive care unit.
When compared with the direct transport group, transferred patients were at increased risk for overall mortality (transfer, 8.9% ; direct, 4. (...)
Mots-clés Pascal : Traumatisme, Indice gravité, Influence, Equipement, Hôpital, Morbidité, Mortalité, Evolution, Etude comparative, Homme
Mots-clés Pascal anglais : Trauma, Severity score, Influence, Equipment, Hospital, Morbidity, Mortality, Evolution, Comparative study, Human
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0484859
Code Inist : 002B16N. Création : 03/02/1998.