Περίληψη:
Objective: The purpose of this study was to evaluate the impact of ATLS
(R) on trauma mortality in a non-trauma system setting. AILS represents
a fundamental element of trauma training in every trauma curriculum.
Nevertheless, there are limited studies in the literature as for the
impact of ATLS training in trauma mortality, especially outside the US.
Design: This is a prospective observational study. The primary end point
was to investigate factors that affect mortality of trauma patients in
our health care system. We performed a multivariate analysis for this
purpose and we identified ATLS certification as a predictor of overall
mortality. Following this finding we stratified patients according to
the severity of injury as expressed by the ISS score and we compared
outcome between those treated by an ATLS certified physician and those
treated by non-certified ones. Main outcome measures: Trauma volume and
demographics of trauma patients, factors that affect mortality of
traumatized patients and mortality between patients treated by ATLS (R)
certified and non-certified physicians.
Results: In total, 8862 trauma patients were included in the analysis.
The majority of trauma patients (5988, 67.6%) were treated by a general
surgeon, followed by those treated by an orthopedic surgeon (2194,
24.8%). There were 446 deaths in the registry but, 260 arrived dead in
the Emergency Department and were excluded from the analysis.
Multivariate analysis of the 186 deaths that occurred in the hospital
revealed age, high ISS score, low GCS score, urban location of injury,
neck injury and ATLS (R) certification as factors predisposing to
mortality. Cross tabulation of ATLS (R) certification and ISS of the
trauma patients shows that those treated by certified physicians died
more often in all subcategories of ISS score (p<0.05).
Conclusions: In Greece, with no formal trauma system implementation.
ATLS (R) certified physicians achieve worse outcomes than their
non-certified colleagues when managing trauma patients. We believe that
these findings must be interpreted in the context of the National health
care system. There is considerable room for improvement in our country,
and further analysis is required. (C) 2010 Elsevier Ireland Ltd. All
rights reserved.
Συγγραφείς:
Drimousis, Panagiotis G.
Theodorou, Dimitrios
Toutouzas,
Konstantinos
Stergiopoulos, Spiros
Delicha, Eumorfia M. and
Giannopoulos, Panagiotis
Larentzakis, Antreas
Katsaragakis,
Stylianos
