Stabilization of rural multiple-trauma patients at level III emergency departments before transfer to a level I regional trauma center.
To determine whether triage and stabilization of severely injured rural trauma victims in outlying Level III emergency departments before transfer to Level I trauma centers results in outcomes similar to national normative data.
Retrospective review of trauma transfers and deaths during a 4-year period.
Two Level 111 EDs in rural, upstate New York and an urban Level I regional trauma center.
Fifty multiple-trauma victims with a Trauma Triage Score (T-RTS) of ¾11 or less.
Forty-three patients were stabilized before transfer, and 7 died in the rural Level III ED.
There were 45 blunt injuries and 5 penetrating injuries.
Mean patient age was 34 years (range, 9 months to 97 years).
The Revised Trauma Score (RTS) on admission to the Level III ED was calculated for each patient (median score, 5.97 ; interquartile range (IQR), 4.09 to 6.90), as was the ultimate Injury Severity Score (ISS) (median score, 23 ; IQR, 13 to 29).
With TRISS methodology, probabilities of survival (Ps) and death (Pd) were calculated.
Results were compared with the Major Trauma Outcome Study (MTOS) by use of current coefficients derived from Walker-Duncan regression analysis of MTOS data.
The predicted number of deaths was 13.5, whereas the actual number was 12, Z statistic, - 710.
There were two unexpected survivors and three unexpected deaths.
Mots-clés Pascal : Polytraumatisme, Stabilisation, Malade, Echelon local, Echelon régional, Unité soin intensif, Etats Unis, Amérique du Nord, Amérique, Transport sanitaire, Organisation santé, Homme, Traumatisme
Mots-clés Pascal anglais : Multiple injury, Stabilization, Patient, Local scope, Regional scope, Intensive care unit, United States, North America, America, Medical transport, Public health organization, Human, Trauma
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0208438
Code Inist : 002B27B14C. Création : 09/06/1995.