PDF(Pubmed)
Abstract：
UNASSIGNED: Traumatic rib fractures present a considerable risk to patient well-being, contributing to morbidity and mortality in trauma patients. To address the risks associated with rib fractures, evidence-based interventions have been implemented, including effective pain management, pulmonary hygiene, and early walking. Vancouver General Hospital, a level 1 trauma center in British Columbia, Canada, developed a comprehensive multidisciplinary chest trauma clinical practice guideline (CTCPG) to optimize the management of patients with rib fractures. This prospective cohort study aimed to assess the impact of the CTCPG on pain management interventions and patient outcomes.
UNASSIGNED: The study involved patients admitted between January 1, 2021 and December 31, 2021 (post-CTCPG cohort) and a historical control group admitted between November 1, 2018 and December 31, 2019 (pre-CTCPG cohort). Patient data were collected from patient charts and the British Columbia Trauma Registry, including demographics, injury characteristics, pain management interventions, and relevant outcomes.
UNASSIGNED: Implementation of the CTCPG resulted in an increased use of multimodal pain therapy (99.4% vs 96.1%; p=0.03) and a significant reduction in the incidence of delirium in the post-CTCPG cohort (OR 0.43, 95% CI 0.21 to 0.80, p=0.0099). There were no significant differences in hospital length of stay, ICU (intensive care unit) days, non-invasive positive pressure ventilation requirement, ventilator days, pneumonia incidence, or mortality between the two cohorts.
UNASSIGNED: Adoption of a CTCPG improved chest trauma management by enhancing pain management and reducing the incidence of delirium. Further research, including multicenter studies, is warranted to validate these findings and explore additional potential benefits of the CTCPG in the management of chest trauma patients.
UNASSIGNED: IIb.
UNASSIGNED: The study involved patients admitted between January 1, 2021 and December 31, 2021 (post-CTCPG cohort) and a historical control group admitted between November 1, 2018 and December 31, 2019 (pre-CTCPG cohort). Patient data were collected from patient charts and the British Columbia Trauma Registry, including demographics, injury characteristics, pain management interventions, and relevant outcomes.
UNASSIGNED: Implementation of the CTCPG resulted in an increased use of multimodal pain therapy (99.4% vs 96.1%; p=0.03) and a significant reduction in the incidence of delirium in the post-CTCPG cohort (OR 0.43, 95% CI 0.21 to 0.80, p=0.0099). There were no significant differences in hospital length of stay, ICU (intensive care unit) days, non-invasive positive pressure ventilation requirement, ventilator days, pneumonia incidence, or mortality between the two cohorts.
UNASSIGNED: Adoption of a CTCPG improved chest trauma management by enhancing pain management and reducing the incidence of delirium. Further research, including multicenter studies, is warranted to validate these findings and explore additional potential benefits of the CTCPG in the management of chest trauma patients.
UNASSIGNED: IIb.
摘要：
■创伤性肋骨骨折对患者的健康存在相当大的风险，有助于创伤患者的发病率和死亡率。为了解决与肋骨骨折相关的风险，已经实施了基于证据的干预措施，包括有效的疼痛管理，肺部卫生，早期行走。温哥华总医院,不列颠哥伦比亚省的一个一级创伤中心,加拿大,制定了综合多学科胸部创伤临床实践指南（CTCPG），以优化肋骨骨折患者的治疗。这项前瞻性队列研究旨在评估CTCPG对疼痛管理干预措施和患者预后的影响。
该研究涉及2021年1月1日至2021年12月31日收治的患者（CTCPG后队列）和2018年11月1日至2019年12月31日收治的历史对照组（CTCPG前队列）。患者数据从患者图表和不列颠哥伦比亚省创伤登记处收集，包括人口统计，损伤特征,疼痛管理干预措施，和相关成果。
■CTCPG的实施增加了多模式疼痛治疗的使用（99.4％vs96.1％；p=0.03），并且CTCPG后队列中谵妄的发生率显着降低（OR0.43，95％CI0.21至0.80，p=0.0099）。住院时间没有显着差异，ICU（重症监护病房）天数，无创正压通气要求，呼吸机日，肺炎发病率，或两个队列之间的死亡率。
■采用CTCPG通过加强疼痛管理和降低谵妄发生率来改善胸部创伤管理。进一步研究,包括多中心研究，有必要验证这些发现，并探索CTCPG在胸部创伤患者管理中的其他潜在益处。
■IIb。
该研究涉及2021年1月1日至2021年12月31日收治的患者（CTCPG后队列）和2018年11月1日至2019年12月31日收治的历史对照组（CTCPG前队列）。患者数据从患者图表和不列颠哥伦比亚省创伤登记处收集，包括人口统计，损伤特征,疼痛管理干预措施，和相关成果。
■CTCPG的实施增加了多模式疼痛治疗的使用（99.4％vs96.1％；p=0.03），并且CTCPG后队列中谵妄的发生率显着降低（OR0.43，95％CI0.21至0.80，p=0.0099）。住院时间没有显着差异，ICU（重症监护病房）天数，无创正压通气要求，呼吸机日，肺炎发病率，或两个队列之间的死亡率。
■采用CTCPG通过加强疼痛管理和降低谵妄发生率来改善胸部创伤管理。进一步研究,包括多中心研究，有必要验证这些发现，并探索CTCPG在胸部创伤患者管理中的其他潜在益处。
■IIb。
