Trauma systems around the world: A systematic overview

被引:65
作者
Dijkink, Suzan [1 ]
Nederpelt, Charlie J. [1 ]
Krijnen, Pieta [1 ]
Velmahos, George C. [2 ]
Schipper, Inger B. [1 ]
机构
[1] Leiden Univ, Med Ctr, Leiden, Netherlands
[2] Massachusetts Gen Hosp, Boston, MA 02114 USA
关键词
International trauma system; prehospital care; facility-based care; quality assurance; EMERGENCY MEDICAL-SERVICES; INTERNATIONAL EMS SYSTEMS; CARE SYSTEMS; CURRENT STATE; IMPLEMENTATION; REGISTRIES; MORTALITY; IMPROVEMENTS; SCANDINAVIA; MANAGEMENT;
D O I
10.1097/TA.0000000000001633
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
BACKGROUND: Implementation of trauma care systems has resulted in improved patient outcomes, but international differences obviously remain. Improvement of care can only be established if we recognize and clarify these differences. The aim of the current review is to provide an overview of the recent literature on the state of trauma systems globally. METHODS: The literature review over the period 2000 to 2016 was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Prehospital care, acute hospital care and quality assurance were classified using the World Health Organization Trauma System Maturity Index in four levels from I (least mature) to IV (most mature). RESULTS: The search yielded 93 articles about trauma systems in 32 countries: 23 high-income (HI), 8 middle-income (MI) countries and 1 low-income (LI) country. Trauma-related mortality was highest in the MI and LI countries. Level IV prehospital care with Advanced Life Support was established in 19 HI countries, in contrast to the MI and LI countries where this was only reported in Brazil, China, and Turkey. In 18 HI countries, a Level III/IV hospital-based trauma system was implemented, whereas in nine LI- and MI countries Level I/II trauma systems were seen, mostly lacking dedicated trauma centers and teams. A national trauma registry was implemented in 10 HI countries. CONCLUSION: Despite the presence of seemingly sufficient resources and the evidence-based benefits of trauma systems, only nine of the 23 HI countries in our review have a well-defined and documented national trauma system. Although 90% of all lethal traumatic injuries occur in middle and LI countries, according to literature which our study is limited to, only few of these countries a hold formal trauma system or trauma registry. Much can be gained concerning trauma systems in these countries, but unfortunately, the economic situation of many countries may render trauma systems not at their top priority list. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
引用
收藏
页码:917 / 925
页数:9
相关论文
共 77 条
  • [1] Aharonson-Daniel L, 2007, ISR MED ASSOC J, V9, P347
  • [2] Emergency medical service rescue times in Riyadh
    Al-Ghamdi, AS
    [J]. ACCIDENT ANALYSIS AND PREVENTION, 2002, 34 (04) : 499 - 505
  • [3] Al-Naami MY, 2010, ANN SAUDI MED, V30, P50, DOI [10.5144/0256-4947.59374, 10.4103/0256-4947.59374]
  • [4] Towards an electronic national injury surveillance system in Saudi Arabia
    Alanazi, F.
    Hussain, S. A.
    Mandil, A.
    Alamro, N.
    [J]. EASTERN MEDITERRANEAN HEALTH JOURNAL, 2015, 21 (02) : 140 - 146
  • [5] [Anonymous], RES OPT CAR INJ PAT
  • [6] [Anonymous], TRAUM SYST MAT IND
  • [7] [Anonymous], GLOB BURD DIS DEATH
  • [8] [Anonymous], UNFALLCHIRURG
  • [9] [Anonymous], 2011, DEC ACT ROAD SAF 201
  • [10] Antoljak T, 2013, INJURY, V44, pS3, DOI 10.1016/S0020-1383(13)70188-8