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Der Unfallchirurg

, Volume 118, Issue 3, pp 233–239 | Cite as

Status quo der Boden- und Luftrettung schwerverletzter Patienten

Analyse eines überregionalen Schweizer Traumazentrums
  • S. Günkel
  • M. König
  • R. Albrecht
  • M. Brüesch
  • R. Lefering
  • K. Sprengel
  • C.M.L. Werner
  • H.-P. Simmen
  • G.A. Wanner
Originalien
  • 381 Downloads

Zusammenfassung

Der Einfluss des Transportmittels auf die Mortalität polytraumatisierter Patienten wird nach wie vor kontrovers diskutiert. In der vorliegenden Arbeit wurde an 333 erwachsenen schwerverletzten Patienten, die innerhalb eines Jahres in ein Zentrumsspital in der Schweiz eingewiesen wurden, der Einfluss des Transportmittels auf ihre Überlebenswahrscheinlichkeit untersucht. Der relativ neu etablierte RISC-Score (Revised Injury Severity Classification Score) fand als Zielgröße dabei Anwendung. Es konnte ein geringer, wenn auch nicht statistisch signifikanter Überlebensvorteil für Patienten, welche mit dem Rettungshubschrauber eingewiesen wurden im Vergleich zu den bodengebunden transportierten Patienten nachgewiesen werden („standardized mortality ratio“ 1,06 vs. 1,29). Faktoren, welche die Überlebenswahrscheinlichkeit in der vorliegenden Untersuchung verbessern, sind kurze präklinische Rettungszeiten und der Transport mit dem Notarzt.

Schlüsselwörter

Polytrauma RISC-Score Letalität Rettungshubschrauber Notarzt 

Deployment and efficacy of ground versus helicopter emergency service for severely injured patients

Analysis of a nationwide Swiss trauma center

Abstract

The influence of the transport mode, i.e. Helicopter Emergency Medical Service (HEMS) versus ground-based Emergency Medical Service (EMS) on the mortality of multiple trauma patients is still controversially discussed in the literature. In this study a total of 333 multiple trauma patients treated over a 1-year period in a level I trauma center in Switzerland were analyzed. Using the newly established revised injury severity classification (RISC) score there was a tendency towards a better outcome for patients transported by HEMS (standardized mortality ratio 1.06 for HEMS versus 1.29 for EMS). Overall a short preclinical time and the presence of an emergency physician (EP) were associated with a better outcome.

Keywords

Multiple trauma Injury severity scores Outcome Emergency helicopters Emergency medical services 

Notes

Danksagung

Wir danken Herrn Dr. Kaspar Rufibach und Frau Dr. Michaela Paul, Abteilung Biostatistik der Universität Zürich, für die Betreuung der statistischen Untersuchungen.

Einhaltung ethischer Richtlinien

Interessenkonflikt. S. Günkel, M. König, R. Albrecht, M. Brüesch, R. Lefering, K. Sprengel, C.M.L. Werner, H.-P. Simmen, G.A. Wanner geben an, dass kein Interessenkonflikt besteht. Alle angewandten Verfahren stehen im Einklang mit den ethischen Normen der verantwortlichen Kommission für Forschung am Menschen (institutionell und national) und mit der Deklaration von Helsinki von 1975 in der revidierten Fassung von 2008. Alle Patienten wurden erst nach erfolgter Aufklärung und Einwilligung in die Studie eingeschlossen.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • S. Günkel
    • 1
  • M. König
    • 1
  • R. Albrecht
    • 2
  • M. Brüesch
    • 3
  • R. Lefering
    • 4
  • K. Sprengel
    • 1
  • C.M.L. Werner
    • 1
  • H.-P. Simmen
    • 1
  • G.A. Wanner
    • 1
  1. 1.Klinik für UnfallchirurgieUniversitätsspital ZürichZürichSchweiz
  2. 2.Schweizerische Rettungsflugwacht RegaZürichSchweiz
  3. 3.Institut für AnästhesiologieUniversitätsspital ZürichZürichSchweiz
  4. 4.Institut für Forschung in der Operativen MedizinUniversität Witten/HerdeckeKölnDeutschland

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