Objective： To explore the features, treatment outcomes and reasons for misdiagnosis in patients with multiple trauma, so as to decrease the incidence of misdiagnosis.Methods： A total of 3 163 patients with multiple ...Objective： To explore the features, treatment outcomes and reasons for misdiagnosis in patients with multiple trauma, so as to decrease the incidence of misdiagnosis.Methods： A total of 3 163 patients with multiple trauma who were admitted in our department from August 1997 to August 2008, were retrospectively studied to compare the features of diagnosis and treatment. There were 2 117 males （66.93%） and 1 046 females （33.07%） with the mean age of 36.46 years （range, 14-80 years）. Parameters such as general status, traumatic condition, diagnosis and treatment situation, prognosis and mortality were analyzed. The differences between misdiagnosis group and correct diagnosis group were compared in terms of severity of injury, complications and treatment outcomes to elucidate the cause and prevention of misdiagnosis.Results： The misdiagnosis rate of multiple trauma in this study was 16.19%. The major anatomic sites misdiagnosed were limbs and pelvis （299 positions, 39.50%）, abdominal region and pelvic organ （148 positions, 19.55%）,and thoracic region （109 positions, 14.40%）. In misdiagnosis group, ISS, length of hospital stay, rates of disturbance of consciousness, critical cases and shock cases were 33.78± 19.64, （23.59±7.26） days, 49.22%, 33.01% and 47.46%,respectively, which were significantly higher than those of the correct diagnosis group （P〈0.01）. And the data showed that the more serious the injury was, the higher the rate of misdiagnosis would be. The rate of primary diagnosis by trauma surgeons in correct diagnosis group was 75.78%, significantly higher than that of the misdiagnosis group （ x2=382.01,P〈0.01）. The mortality rate of the mi sdiagnosis group was 2.93%, which was significantly higher than that for all patients （ x2=5.22, P〈0.05）.Conclusions： The results indicated that patients with severe multiple trauma are at high risk of misdiagnosis in early treatment. The mortality rate of misdiagnosed patients is higher than the correctly-diagnosed patients. To prevent misdiagnosis, physicians need to take great care to conduct thorough clinical examinations and repeated evaluation.展开更多
Objective： To study the emergency care effect of in-hospital severe trauma patients with the injury severity score （ISS）≥ 16 after medical staff received advanced trauma life support （ATLS） training.Methods： AT...Objective： To study the emergency care effect of in-hospital severe trauma patients with the injury severity score （ISS）≥ 16 after medical staff received advanced trauma life support （ATLS） training.Methods： ATLS training was implemented by lectures,scenarios, field practices, and examinations. The clinical effect of in-hospital severe trauma care was compared 2 years before and after ATLS training.Results： During 2 years （from January 1, 2004, to December 31, 2005） before ATLS training, 438 cases of severe trauma were admitted and treated emergently in our department. Among them, ISS score was 28.6±7.8 on average, and 87 cases died with the mortality of 19.9%. The duration in emergency department and from admission to operation were 69.5 min±l 1.5 min and 89.6 min±9.3 min respectively. Two years （from January 1,2007, to December 31, 2008） after ATLS training, 382 cases of severe trauma were admitted and treated. The ISS was 25.3 ±6.1 on average and 62 cases died with the mortality of 15.1%. The duration in emergency department and from admission to operation were 47.8 min±10.7 min and 61.5 min±9.9 min respectively. The ISS score showed no significant difference between the two groups （P＞0.05）, but the mortality, the duration in emergency department and from admission to operation were markedly decreased after ATLS training and showed significant difference between the two groups （P＜0.05）.Conclusion： ATLS course training can improve the emergency care effect of in-hospital severe trauma patients,and should be put into practice as soon as possible in China.展开更多
文摘Objective： To explore the features, treatment outcomes and reasons for misdiagnosis in patients with multiple trauma, so as to decrease the incidence of misdiagnosis.Methods： A total of 3 163 patients with multiple trauma who were admitted in our department from August 1997 to August 2008, were retrospectively studied to compare the features of diagnosis and treatment. There were 2 117 males （66.93%） and 1 046 females （33.07%） with the mean age of 36.46 years （range, 14-80 years）. Parameters such as general status, traumatic condition, diagnosis and treatment situation, prognosis and mortality were analyzed. The differences between misdiagnosis group and correct diagnosis group were compared in terms of severity of injury, complications and treatment outcomes to elucidate the cause and prevention of misdiagnosis.Results： The misdiagnosis rate of multiple trauma in this study was 16.19%. The major anatomic sites misdiagnosed were limbs and pelvis （299 positions, 39.50%）, abdominal region and pelvic organ （148 positions, 19.55%）,and thoracic region （109 positions, 14.40%）. In misdiagnosis group, ISS, length of hospital stay, rates of disturbance of consciousness, critical cases and shock cases were 33.78± 19.64, （23.59±7.26） days, 49.22%, 33.01% and 47.46%,respectively, which were significantly higher than those of the correct diagnosis group （P〈0.01）. And the data showed that the more serious the injury was, the higher the rate of misdiagnosis would be. The rate of primary diagnosis by trauma surgeons in correct diagnosis group was 75.78%, significantly higher than that of the misdiagnosis group （ x2=382.01,P〈0.01）. The mortality rate of the mi sdiagnosis group was 2.93%, which was significantly higher than that for all patients （ x2=5.22, P〈0.05）.Conclusions： The results indicated that patients with severe multiple trauma are at high risk of misdiagnosis in early treatment. The mortality rate of misdiagnosed patients is higher than the correctly-diagnosed patients. To prevent misdiagnosis, physicians need to take great care to conduct thorough clinical examinations and repeated evaluation.
文摘Objective： To study the emergency care effect of in-hospital severe trauma patients with the injury severity score （ISS）≥ 16 after medical staff received advanced trauma life support （ATLS） training.Methods： ATLS training was implemented by lectures,scenarios, field practices, and examinations. The clinical effect of in-hospital severe trauma care was compared 2 years before and after ATLS training.Results： During 2 years （from January 1, 2004, to December 31, 2005） before ATLS training, 438 cases of severe trauma were admitted and treated emergently in our department. Among them, ISS score was 28.6±7.8 on average, and 87 cases died with the mortality of 19.9%. The duration in emergency department and from admission to operation were 69.5 min±l 1.5 min and 89.6 min±9.3 min respectively. Two years （from January 1,2007, to December 31, 2008） after ATLS training, 382 cases of severe trauma were admitted and treated. The ISS was 25.3 ±6.1 on average and 62 cases died with the mortality of 15.1%. The duration in emergency department and from admission to operation were 47.8 min±10.7 min and 61.5 min±9.9 min respectively. The ISS score showed no significant difference between the two groups （P＞0.05）, but the mortality, the duration in emergency department and from admission to operation were markedly decreased after ATLS training and showed significant difference between the two groups （P＜0.05）.Conclusion： ATLS course training can improve the emergency care effect of in-hospital severe trauma patients,and should be put into practice as soon as possible in China.
