| Objective:Multiple trauma are often complicated and urgent,easy to miss diagnosis and high mortality;However,mountain cities are difficult to rescue because of their complex terrain;Therefore,rapid assessment of the condition of multiple trauma,shortening the rescue time,taking effective first-aid measures,and reducing the fatality rate of multiple trauma are the difficulties that emergency physicians in mountain cities need to overcome.At present,it is not clear whether the construction of trauma centers can effectively improve the prognosis of patients with severe multiple trauma in mountain cities.The purpose of this study is to explore the characteristics of multiple trauma patients in mountain cities and the advantages of trauma center construction in treating multiple trauma patients through this retrospective analysis.Methods:183 cases of severe multiple trauma admitted to Huangshan people’s Hospital from June 2018 to June 2020 were retrospectively analyzed.According to the time before and after the establishment of the trauma center(July 2019),they were divided into the study group(n=94)and the control group(n=89).Secondly,patients transferred from our hospital(n=87)were divided into the trauma center group(n=47)and the non trauma center group(n=40)according to the time before and after the establishment of the trauma center.Patients with multiple trauma transferred from other hospitals after the establishment of the trauma center were classified into the external hospital of trauma center group(n=47),Data such as gender,age,injury factors,injury severity score(ISS),emergency surgical treatment rate,interventional treatment rate,pre-hospital to emergency room time,emergency room stay time,mechanical ventilation time,hospitalization time,Intensive care unit(ICU)stay time,total hospitalization expenses,disability rate and mortality rate were collected for all patients.Mann Whitney U test or t test was used to compare and analyze the age,ISS score,pre-hospital to emergency room stay time,mechanical ventilation time,hospitalization time,ICU stay time,total hospitalization cost and other clinical data of patients in the study group,the control group,the trauma center group and the non trauma center group.χ~2 was used to compare the gender,ISS score classification,emergency surgical treatment rate,interventional treatment rate,disability rate and mortality rate of the two groups of patients;Quantitative data are expressed as (?)±SD,and qualitative data are expressed as number of cases and percentage[n(%)];SPSS 22.0 software was used for statistical analysis.P<0.05 means that the difference is statistically significant.Results:A total of 183 patients were included in this study,of which 87 were transferred by our hospital.According to the time of establishment of the trauma center,they were divided into study group and control group,trauma center group and non trauma center group.The ISS score of the patients in the study group were significantly higher than that of the control group(29.2 ± 8.4 vs 23.6 ± 6.0,U=2473,P<0.001),while the pre-hospital to emergency room time(101.4 ± 63.4 vs 150.2 ± 91.6,U=2811,P<0.001),the emergency room stay time(75.9 ± 41.1 vs 96.9 ± 49.8,U=3827,P<0.001),the mechanical ventilation time(6.7 ± 5.1 vs 10.4 ± 7.6,U=1837,P<0.001),and the ICU stay time(13.6± 11.0 vs 18.0 ± 14.1,U=3327,P=0.016),the disability rate(9.6%vs 20.2%,χ~2=4.123,P=0.042)and mortality rate(10.6%vs 21.3%,χ~2=3.932,P=0.047)of patients in the study group were significantly lower than that of the control group;However,there were no significant difference in gender,age,transfer rate of external hospital,injury factors,emergency surgical treatment rate,interventional treatment rate,hospitalization time and total hospitalization cost(P>0.05).The ISS score of patients in the trauma center group were significantly higher than that in the non trauma center group(27.5±7.7 vs 24.1±6.4,U=689,P=0.031),while the pre-hospital to emergency room time(85.1±46.3 vs 107.5±68.9,U=730,P=0.039),the emergency room stay time(73.6±40.6 vs 105.6±55.5,U=760,P=0.001),the mechanical ventilation time(5.8 ± 4.5 vs 10.1 ± 7.1,U=363,P=0.009),the ICU stay time(12.5 ± 9.8 vs 19.9 ± 16.8,U=667,P=0.019),the disability rate(6.4%vs 20.0%,χ~2=3.638,P=0.049)and the mortality rate(4.3%vs 22.5%,χ~2=6.512,P=0.011)of patients in the trauma center group were significantly lower than that of the non trauma center group;There was no significant difference between the two groups in gender,age,transfer rate of external hospital,injury factors,emergency surgical treatment rate,interventional treatment rate,hospitalization time and total hospitalization cost(P>0.05).The ISS score(30.9 ± 8.9 vs 27.5 ± 7.7,t=2.103,P=0.041)and mortality rate(17.0%vs 4.3%,χ~2=4.029,P=0.045)of patients in the external hospital of trauma center group were significantly higher than that in the trauma center group;There was no significant difference between the two groups in injury factors,pre-hospital to emergency room time,emergency room stay time,mechanical ventilation time,ICU stay time and disability rate(P>0.05).Conclusion:The establishment of the trauma center in the mountain area can shorten the rescue time,improve the rescue rate,reduce the time of mechanical ventilation and ICU stay for severe multiple trauma patients,improve the prognosis of patients,avoid the limitation of the treatment of trauma patients due to too detailed division of departments,and reduce the mortality and disability rate of patients.It is worth popularizing. |
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