Impact de la mise en place d'un réseau de soins en traumatologie sur la mortalité des patients traumatisés graves du bassin [Impact of a trauma network on mortality in patients with severe pelvic trauma]

Details

Serval ID
serval:BIB_128295476D6E
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Impact de la mise en place d'un réseau de soins en traumatologie sur la mortalité des patients traumatisés graves du bassin [Impact of a trauma network on mortality in patients with severe pelvic trauma]
Journal
Annales francaises d'anesthesie et de reanimation
Author(s)
Bouzat P., Broux C., Ageron F.X., Gros I., Levrat A., Thouret J.M., Thony F., Tonetti J., Payen J.F.
ISSN
1769-6623 (Electronic)
ISSN-L
0750-7658
Publication state
Published
Issued date
12/2013
Peer-reviewed
Oui
Volume
32
Number
12
Pages
827-832
Language
french
Notes
Publication types: English Abstract ; Journal Article ; Observational Study
Publication Status: ppublish
Abstract
To evaluate the impact of a regional trauma network on intra-hospital mortality rates of patients admitted with severe pelvic trauma.
Retrospective observational study.
Sixty-five trauma patients with serious pelvic fracture (pelvic abbreviated injury scale [AIS] score of 3 or more).
Demographic, physiologic and biological parameters were recorded. Observed mortality rates were compared to predicted mortality according to the Trauma Revised Injury Severity Score methodology adjusted by a case mix variation model.
Twenty-nine patients were admitted in a level I trauma centre (reference centre) and 36 in level II trauma centres (centres with interventional radiology facility and/or neurosurgery). Patients from the level I trauma centre were more severely injured than those who were admitted at the level II trauma centres (Injury Severity Score [ISS]: 30 [13-75] vs 22 [9-59]; P<0.01). Time from trauma to hospital admission was also longer in level I trauma centre (115 [50-290] min vs 90 [28-240] min, P <0.01). Observed mortality rates (14%; 95% confidence interval, 95% CI, [1-26%]) were lower than the predicted mortality (29%; 95% CI [13-44%]) in the level I trauma centre. No difference in mortality rates was found in the level II trauma centres.
The regional trauma network could screen the most severely injured patients with pelvic trauma to admit them at a level I trauma centre. The observed mortality of these patients was lower than the predicted mortality despite increased time from trauma to admission.
Keywords
Abbreviated Injury Scale, Adolescent, Adult, Aged, Aged, 80 and over, Blood Pressure/physiology, Emergency Medical Services, Female, Humans, Injury Severity Score, Male, Middle Aged, Patient Admission, Pelvis/injuries, Regional Medical Programs/organization & administration, Retrospective Studies, Time Factors, Trauma Centers/organization & administration, Wounds and Injuries/mortality, Wounds and Injuries/therapy, Young Adult, Mortality, Mortalité, Multiple trauma, Pelvic trauma, Polytraumatisme, Réseau de soins, Trauma network, Traumatisme du bassin
Pubmed
Web of science
Create date
09/03/2021 13:14
Last modification date
02/03/2022 7:35
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