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  1. Ineffectiveness of on-site intravenous lines : Is prehospital time the culprit ? Discussion.

    Article, Communication - En anglais

    Annual Meeting of the American Association for the Surgery of Trauma. Annual Meeting of the Trauma Association of Canada. Halifax, Nova Scotia (CAN), 1995/09/27.

    The purpose of the present study was to test the association between on-site intravenous fluid replacement and mortality in patients with severe trauma.

    The effect of prehospital time on this association was also evaluated.

    The design was that of an observational quasi-experimental study comparing 217 patients who had on-site intravenous fluid replacement (IV group) with an equal number of matched patients for whom this intervention was not performed (no-IV group).

    The patients were individually matched on their Prehospital Index obtained at the scene and were included in the study if they had an on-site Prehospital Index score>3 and were transported alive to the hospital.

    The outcome measure of interest was mortality because of injury.

    The patients in the IV group had a significantly lower mean age (37 vs. 45 years ; p<0.001) and higher incidence of injuries to the head or neck (46 vs. 32% ; p=0.004), chest (34 vs. 17% ; p<0.001), and abdomen (28 vs. 12% ; p<0.001).

    The IV group also had a higher proportion of patients injured by motor vehicle crashes (41 vs. 27% ; p=0.003), firearms (9 vs. 2% ; p=0.001), and stabbing (20 vs. 9% ; p=0.001).

    The rate of extremity injuries (38 vs. 59% ; p<0.001) and falls (12 vs. 40% ; p<0.001) was lower for the IV group.

    In addition, the mean Injury Severity Score was significantly higher for the IV group (15 vs. 9 ; p<0.001).

    The mortality rates for the IV and no-IV groups were 23 and 6% (p<0.001). (...)

    Mots-clés Pascal : Traumatisme, Indice gravité, Traitement, Réanimation, Technique, Perfusion, Epidémiologie, Facteur risque, Mortalité, Période préhospitalière, Homme

    Mots-clés Pascal anglais : Trauma, Severity score, Treatment, Resuscitation, Technique, Perfusion, Epidemiology, Risk factor, Mortality, Prehospital period, Human

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    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 98-0002159

    Code Inist : 002B27B14C. Création : 17/04/1998.