This report uses a mathematical modeling system to define optimal orthopedic coverage for trauma centers.
Data from 2,325 patients treated with emergency orthopedic operations within 24 hours of admission at 78 randomly sampled and at four totally sampled verified centers were used to create a profile of (1) admission by month, day, and hour ; (2) operation times ; and (3) operation duration.
The reason for operation included (1) open fracture or crush (809 patients) ; (2) irreducible dislocations (164 patients) ; (3) fracture with vascular injury (seven patients) ; (4) dislocation with vascular injury (17 patients) ; (5) compartment syndrome (11 patients) ; (6) femoral neck fracture in young patients (36 patients) ; (7) combination of categories 1 to 6 (70 patients) ; (8) fracture with multiple injuries (171 patients) ; and (9) urgent not emergent (1,040 patients).
The program defined the frequency that an injured patient needing an orthopedic consult would wait beyond 30 minutes because the orthopedic surgeon was doing a trauma related operation at a center with one or two orthopedic surgeons on call.
The probability that a patient cannot be seen promptly by one orthopedic surgeon in a center doing 25,50,75,100,200, and 300 emergency procedures per year is 0.17,0.74,1.6,3.1,12.5, and 28 patients per year.
When two are on call, 1.3 patients, yearly, will wait more than 30 minutes in a center doing 300 emergency procedures. (...)
Mots-clés Pascal : Fracture, Os, Luxation, Loge musculaire membre syndrome, Polytraumatisme, Modélisation, Incidence, Distribution temporelle, Temps attente, Temps traitement, Optimisation programme, Disponibilité, Etude statistique, Homme, Système ostéoarticulaire pathologie, Traumatisme, Appareil circulatoire pathologie, Vaisseau sanguin pathologie, Artère pathologie, Muscle strié pathologie, Informatique biomédicale
Mots-clés Pascal anglais : Fracture, Bone, Luxation, Compartment syndrome, Multiple injury, Modeling, Incidence, Time distribution, Waiting time, Processing time, Program optimization, Availability, Statistical study, Human, Diseases of the osteoarticular system, Trauma, Cardiovascular disease, Vascular disease, Arterial disease, Striated muscle disease, Biomedical data processing
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0238429
Code Inist : 002B28B. Création : 11/09/1998.