Titre
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]
Type
article
Institution
Externe
Auteur(s)
Bouzat, P.
Auteure/Auteur
Broux, C.
Auteure/Auteur
Ageron, F.X.
Auteure/Auteur
Gros, I.
Auteure/Auteur
Levrat, A.
Auteure/Auteur
Thouret, J.M.
Auteure/Auteur
Thony, F.
Auteure/Auteur
Tonetti, J.
Auteure/Auteur
Payen, J.F.
Auteure/Auteur
Liens vers les personnes
ISSN
1769-6623
Statut éditorial
Publié
Date de publication
2013-12
Volume
32
Numéro
12
Première page
827
Dernière page/numéro d’article
832
Peer-reviewed
Oui
Langue
français
Notes
Publication types: English Abstract ; Journal Article ; Observational Study
Publication Status: ppublish
Publication Status: ppublish
Résumé
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.
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.
Sujets
PID Serval
serval:BIB_128295476D6E
PMID
Date de création
2021-03-09T11:14:03.470Z
Date de création dans IRIS
2025-05-20T13:41:28Z