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首页> 外文期刊>Annals of Surgery >Establishing a Regional Trauma Preventable/Potentially Preventable Death Rate
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Establishing a Regional Trauma Preventable/Potentially Preventable Death Rate

机译：建立区域创伤可预防/可能可预防的死亡率

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Objective: To establish a trauma preventable/potentially preventable death rate (PPPDR) within a heavily populated county in Texas. The National Academies of Sciences estimated the trauma preventable death rate in the United States to be 20%, issued a call for zero preventable deaths, while acknowledging that an accurate preventable death rate was lacking. In this absence, effective strategies to improve quality of care across trauma systems will remain difficult. Methods: A retrospective review of death-related records that occurred during 2014 in Harris County, TX, a diverse population of 4.4 million. Patient demographics, mechanism of injury, cause, timing, and location of deaths were assessed. Deaths were categorized using uniform criteria and recorded as preventable, potentially preventable or nonpreventable. Results: Of 1848 deaths, 85% had an autopsy and 99.7% were assigned a level of preventability, resulting in a trauma PPPDR of 36.2%. Sex, age, and race/ethnicity varied across preventability categories (P< 0.01). Of 847 prehospital deaths, 758 (89.5%) were nonpreventable. Among 89 prehospital preventable/potentially preventable (P/PP) deaths, hemorrhage accounted for 55.1%. Of the 657 initial acute care setting deaths, 292 (44.4%) were P/PP; of these, hemorrhage, sepsis, and traumatic brain injury accounted for 73.3%. Of 339 deaths occurring after initial hospitalization, 287 (84.7%) were P/PP, of these 117 resulted from sepsis and 31 from pulmonary thromboembolism, accounted for 51.6%. Conclusions: The trauma PPPDR was almost double that estimated by the National Academies of Sciences. Data regarding P/PP deaths offers opportunity to target research, prevention, intervention, and treatment corresponding to all phases of the trauma system.
机译：目的：在德克萨斯州大量人口县内建立创伤可预防/潜在可预防的死亡率（PPPDR）。国家科学学院估计，美国的创伤可预防死亡率为20％，发出零可预防死亡的呼吁，同时承认缺乏准确的可预防的死亡率。在这种缺失中，改善创伤系统的有效策略将仍然困难。方法：对2014年哈里斯县，德克萨斯州举行的死亡相关记录的回顾性审查，多元化人口440万。评估患者人口统计学，伤害机制，原因，时间和死亡的位置。使用统一标准进行分类，并记录为可预防，潜在可预防或不可申请的死亡。结果：1848年死亡人数为85％，尸检85％，99.7％被赋予可预防性水平，导致创伤PPPD 36.2％。性别，年龄和种族/种族在预防性范围内变化（P <0.01）。 847例预孢子死亡，758（89.5％）是非申请。在89个预孢子预防/可能预防（P / PP）死亡中，出血占55.1％。在657个初始急性护理环境中，292（44.4％）为P / PP;其中出血，败血症和创伤性脑损伤占73.3％。在初始住院后发生的339例死亡，287（84.7％）为P / PP，其中117个由败血症和31来自肺血栓栓塞，占51.6％。结论：Trauma PPPDR几乎是国家科学院估计的两倍。关于P / PP死亡的数据为目标，预防，干预和对应于创伤系统的所有阶段进行研究，预防，干预和治疗的数据提供了机会。

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