Clinical exploration of treating the patients of severe multiple injuries with comprehensive trauma center mode

Jin Xiaoxiang; Liu Yan; Ma Jimin; Ye Fang; Tang Jianhui; Pan Jinge

doi:10.3969/j.issn.1002-1949.2024.09.009

Abstract：Objective To explore a closed-loop regional trauma treatment system based on the intensive care Unit(ICU)trauma unit in general hospitals and integrated pre-hospital and in-hospital treatment,and to replace independent trauma centers in developed countries with comprehensive trauma centers and multidisciplinary treatment(MDT)teams in general hospitals,and to explore an effective mode of trauma system construction in this region.Methods A retrospective case-control study was used to analyze the clinical data of 251 patients with severe multiple injuries in the two years before and after January 2021,126 patients with severe multiple injuries were treated with comprehensive trauma center mode in which the trauma unit of ICU played a leading role from January 2021 to June 2023 as the observation group,and 125 patients with severe multiple injuries were treated with MDT mode from January 2019 to December 2020 as the control group.The general data of the patients in two groups were analyzed,the 28-day fatality rate of the patients in two groups was observed and recorded,and the time of staying in the emergency room,the time of starting emergency surgery and the completion time of image examination were analyzed and recorded.Results There was no significant difference in acute physiology and chronic health evaluation Ⅱ(APACHE Ⅱ)and injury severity score(ISS)between the two groups(P＞0.05),and the 28-day fatality rate in the observation group was significantly lower than that in the control group(P＜0.05).At the same time,the completion time of image examination(min:14.40±3.10 vs.26.00±5.28),the time of staying in the emergency room(min:32.90±10.65 vs.68.20±21.33)and the emergency operation time(min:39.80±13.72 vs.108.10±59.94 min)of the observation group were significantly shorter than those of the control group,the difference was statistically significant(P＜0.001).Conclusions The establishment of a comprehensive trauma center mode led by the trauma unit of ICU can achieve an integrated process of severe trauma treatment,standardize severe trauma treatment system,improve the success rate of treatment,and greatly shorten the treatment time for the patients with severe multiple injuries,which is worthy of clinical promotion.