Effects of Trauma Center Establishment on the Clinical Characteristics and Outcomes of Patients with Traumatic Brain Injury : A Retrospective Analysis from a Single Trauma Center in Korea

被引:0
作者
Kim, Jang Soo [1 ]
Jeong, Sung Woo [1 ]
Ahn, Hyo Jin [2 ]
Hwang, Hyun Ju [2 ]
Kyoung, Kyu-Hyouck [2 ]
Kwon, Soon Chan [1 ]
Kim, Min Soo [1 ,2 ]
机构
[1] Univ Ulsan, Coll Med, Ulsan Univ Hosp, Dept Neurosurg, 877 Bangeojinsunhwando Ro, Ulsan 44033, South Korea
[2] Univ Ulsan, Coll Med, Ulsan Univ Hosp, Ctr Trauma, Ulsan, South Korea
基金
新加坡国家研究基金会;
关键词
Trauma centers; Brain injuries; Traumatic; Glasgow coma scale; Glasgow outcome scale; Mortality; SEVERITY SCORE; MORTALITY; IMPACT; SURVIVAL; SYSTEM;
D O I
10.3340/jkns.2018.0037
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective : To investigate the effects of trauma center establishment on the clinical characteristics and outcomes of trauma patients with traumatic brain injury (TBI). Methods : We enrolled 322 patients with severe trauma and TBI from January 2015 to December 2016. Clinical factors, indexes, and outcomes were compared before and after trauma center establishment (September 2015). The outcome was the Glasgow outcome scale classification at 3 months post-trauma. Results : Of the 322 patients, 120 (37.3%) and 202 (62.7%) were admitted before and after trauma center establishment, respectively. The two groups were significantly different in age (p=0.038), the trauma location within the city (p=0.010), the proportion of intensive care unit (ICU) admissions (p=0.001), and the emergency room stay time (p<0.001). Mortality occurred in 37 patients (11.5%). Although the preventable death rate decreased from before to after center establishment (23.1% vs. 12.5%), the difference was not significant. None of the clinical factors, indexes, or outcomes were different from before to after center establishment for patients with severe TBI (Glasgow coma scale score <= 8). However, the proportion of inter-hospital transfers increased and the time to emergency room arrival was longer in both the entire cohort and patients with severe TBI after versus before trauma center establishment. Conclusion : We confirmed that for patients with severe trauma and TBI, establishing a trauma center increased the proportion of ICU admissions and decreased the emergency room stay time and preventable death rate. However, management strategies for handling the high proportion of inter-hospital transfers and long times to emergency room arrival will be necessary.
引用
收藏
页码:232 / 242
页数:11
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