Zusammenfassung
Der Einfluss des Transportmittels auf die Mortalität polytraumatisierter Patienten wird nach wie vor kontrovers diskutiert. In der vorliegenden Arbeit wurde an 333 erwachsenen schwerverletzten Patienten, die innerhalb eines Jahres in ein Zentrumsspital in der Schweiz eingewiesen wurden, der Einfluss des Transportmittels auf ihre Überlebenswahrscheinlichkeit untersucht. Der relativ neu etablierte RISC-Score (Revised Injury Severity Classification Score) fand als Zielgröße dabei Anwendung. Es konnte ein geringer, wenn auch nicht statistisch signifikanter Überlebensvorteil für Patienten, welche mit dem Rettungshubschrauber eingewiesen wurden im Vergleich zu den bodengebunden transportierten Patienten nachgewiesen werden („standardized mortality ratio“ 1,06 vs. 1,29). Faktoren, welche die Überlebenswahrscheinlichkeit in der vorliegenden Untersuchung verbessern, sind kurze präklinische Rettungszeiten und der Transport mit dem Notarzt.
Abstract
The influence of the transport mode, i.e. Helicopter Emergency Medical Service (HEMS) versus ground-based Emergency Medical Service (EMS) on the mortality of multiple trauma patients is still controversially discussed in the literature. In this study a total of 333 multiple trauma patients treated over a 1-year period in a level I trauma center in Switzerland were analyzed. Using the newly established revised injury severity classification (RISC) score there was a tendency towards a better outcome for patients transported by HEMS (standardized mortality ratio 1.06 for HEMS versus 1.29 for EMS). Overall a short preclinical time and the presence of an emergency physician (EP) were associated with a better outcome.
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Danksagung
Wir danken Herrn Dr. Kaspar Rufibach und Frau Dr. Michaela Paul, Abteilung Biostatistik der Universität Zürich, für die Betreuung der statistischen Untersuchungen.
Einhaltung ethischer Richtlinien
Interessenkonflikt. S. Günkel, M. König, R. Albrecht, M. Brüesch, R. Lefering, K. Sprengel, C.M.L. Werner, H.-P. Simmen, G.A. Wanner geben an, dass kein Interessenkonflikt besteht. Alle angewandten Verfahren stehen im Einklang mit den ethischen Normen der verantwortlichen Kommission für Forschung am Menschen (institutionell und national) und mit der Deklaration von Helsinki von 1975 in der revidierten Fassung von 2008. Alle Patienten wurden erst nach erfolgter Aufklärung und Einwilligung in die Studie eingeschlossen.
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Günkel, S., König, M., Albrecht, R. et al. Status quo der Boden- und Luftrettung schwerverletzter Patienten. Unfallchirurg 118, 233–239 (2015). https://doi.org/10.1007/s00113-014-2567-6
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DOI: https://doi.org/10.1007/s00113-014-2567-6