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http://ir.fmu.ac.jp/dspace/handle/123456789/468
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タイトル: | Is preoperative period associated with severity and unexpected death of injured patients needing emergency trauma surgery? |
著者: | Ono, Yuko Yokoyama, Hideyuki Matsumoto, Akinori Kumada, Yoshibumi Shinohara, Kazuaki Tase, Choichiro |
学内所属: | 救急医療学講座 |
誌名/書名: | Journal of anesthesia |
巻: | 28 |
号: | 3 |
開始ページ: | 381 |
終了ページ: | 389 |
発行日: | 2014年6月 |
抄録: | Purpose: Early operative control of hemorrhage is the key to saving the lives of severe trauma patients. We investigated whether emergency room (ER) stay time (time from the ER to the operating room [OR]) is associated with trauma severity and unexpected trauma death (Trauma and Injury Severity Score [TRISS] method-based Probability of survival [Ps] ≥0.5 but died) of injured patients needing emergency trauma surgery. Methods: We performed a retrospective review of call trauma patients requiring emergency surgery and all patients with pelvic fractures requiring transcatheter arterial embolization at our hospital from January 2002 to December 2012. We analyzed the relationships among injury severity on ER admission (Injury Severity Score [ISS]; Revised Trauma Score (RTS); Ps; Shock Index (SI); American Society of Anesthesiologists Physical Status [ASA-PS]); mortality rate; unexpected trauma death rate; and ER stay time. Results: ER stay times were significantly shorter for patients with life-threating conditions (RTS <6.0 [p<0.01], Ps <0.5 [p<0.001], SI ≥1.0 [p<0.01], and ASA-PS ≥4E [p<0.001]). In particular, ER stay time was inversely related to injury severity up to 120 minutes. The risk of unexpected trauma death significantly increased as ER stay time increased over 90 minutes (p<0.01). Conclusions: Our results suggest that every medical staff should work together effectively on high-risk patients in the ER, bringing them immediately to the OR according to their level of risk. If injured patients need emergency trauma surgery, ER stay times should be kept as short as possible to reduce unexpected trauma death. |
出版者: | Springer |
本文の言語: | eng |
このページのURI: | http://ir.fmu.ac.jp/dspace/handle/123456789/468 |
本文URL: | http://ir.fmu.ac.jp/dspace/bitstream/123456789/468/1/JAnesth_28_p381.pdf |
ISSN: | 0913-8668 1438-8359 |
DOI: | 10.1007/s00540-013-1727-0 |
PubMed番号: | 24141883 |
異版(出版者版等): | http://dx.doi.org/10.1007/s00540-013-1727-0 |
権利情報: | © Japanese Society of Anesthesiologists 2013. The final publication is available at link.springer.com |
出現コレクション: | a10 学術雑誌論文等 = Journal Article
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