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Báo cáo y học: " Medical pre-hospital management reduces mortality in severe blunt trauma: a prospective epidemiological study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Medical pre-hospital management reduces mortality in severe blunt trauma: a prospective epidemiological study. | Yeguiayan et al. Critical Care 2011 15 R34 http ccforum.eom content 15 1 R34 KS CRITICAL CARE RESEARCH Open Access Medical pre-hospital management reduces mortality in severe blunt trauma a prospective epidemiological study Ida idac I Vddi Iia an 1molrahi lad narridi Id2 Riooi Idt3 r Hl K ld hmi iraf4 tim ŨC nil airitc. I5 Jean Michel leguiayan Delpiune Garrigue dUistine Binquet Claude Jacquot Jacques Duranteau 6 7 3 f 3 7 1 Claude Marlin Fatima Rayeh Bruno Riou Claire Doniinon-Kopp Marc Freysz The FIRST French Intensive Care Recorded In Severe Trauma Study Group Abstract Introduction Severe blunt trauma is a leading cause of premature death and handicap. However the benefit for the patient of pre-hospital management by emergency physicians remains controversial because it may delay admission to hospital. This study aimed to compare the impact of medical pre-hospital management performed by SMUR Service Mobile d Urgences et de Réanimation with non-medical pre-hospital management provided by fire brigades non-SMUR on 30-day mortality. Methods The FIRST French Intensive care Recorded in Severe Trauma study is a multicenter cohort study on consecutive patients with severe blunt trauma requiring admission to university hospital intensive care units within the first 72 hours. Initial clinical status pre-hospital life-sustaining treatments and Injury Severity Scores ISS were recorded. The main endpoint was 30-day mortality. Results Among 2 703 patients 2 513 received medical pre-hospital management from SMUR and 190 received basic pre-hospital management provided by fire brigades. SMUR patients presented a poorer initial clinical status and higher ISS and were admitted to hospital after a longer delay than non-SMUR patients. The crude 30-day mortality rate was comparable for SMUR and non-SMUR patients 17 and 15 respectively P 0.61 . After adjustment for initial clinical status and ISS SMUR care significantly reduced the risk of 30-day mortality odds ratio OR 0.55 95 CI .