三种检伤分类方法在地震伤儿童群体中的评估价值  

The evaluation value of three triage methodologies in children with earthquake injury

作　　者：王司琪 WANG Siqi(West China School of Medicine,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西临床医学院,四川成都610041

出　　处：《中华灾害救援医学》2022年第4期181-186,共6页Chinese Journal of Disaster Medicine

基　　金：中国科学院战略性先导科技专项(XDA23090502)。

摘　　要：目的Jump START(Jump Simple Triage and Rapid Transport,Jump START)是美国应用最广泛的儿童检伤分类方法,Sacco检伤分类法(Sacco Triage Method,STM)和修正创伤评分(Revised Trauma Score,RTS)在儿童检伤分类中较为普及,以上方法在我国地震伤儿童人群中应用的价值缺乏数据支持。本研究旨在探索三种检伤分类方法在地震伤儿童群体中的评估价值。方法对1164例0~8岁地震伤伤员数据进行回顾性分析,运用Jump START、STM、RTS三种检伤分类方法对伤员进行检伤分类及评分,以死亡、是否进入ICU为结局,比较三种方法的受试者工作特征(Receiver Operating Characteristic curve,ROC)曲线的曲线下面积(Area Under Curve,AUC),采用创伤严重程度评分(Injury Severity Score,ISS)进行相关性分析。结果纳入598例儿童伤员,以死亡为结局,尚不能认为三种检伤分类方法ROC曲线的差异具有统计学意义;以是否进入ICU为结局,Jump START,STM,RTS的AUC分别为0.639、0.660、0.711;Jump START、STM、RTS与ISS评分呈负相关,相关系数分别为-0.267、-0.138、-0.104。结论以是否进入ICU为结局提示RTS的评估价值优于Jump START,Jump START与ISS评分的相关性在三者中最高,仍推荐Jump START作为儿童检伤分类方法。Objective Jump START(Jump Simple Triage and Rapid Transport)is the most widely used pediatric triage methodologies in the United States,while STM(Sacco Triage Method)and RTS(Revised Trauma Score)are relatively popular in pediatric triage.However,the evaluation value of above methodologies in pediatric patients with earthquake injury in China lacks data support.The purpose of this study was to explore the evaluation value of three triage methodologies in pediatric patients with earthquake injury.Methods A retrospective analysis of 1164 earthquake-injured patients aged 0~8 years from the database of West China Hospital were performed with Jump START,STM and RTS,respectively.Based on death and ICU acceptance,the areas under the receiver operator characteristic curve(AUC)were compared to evaluate three triage methodologies.Injury severity score(ISS)was used to analyze the correlation between the three triage methodologies.Results 598 pediatric patients were included.For death as end point,there was no statistically significance between the receiver operator characteristic curves(ROCs)of the three triage methodologies.For ICU acceptance,AUC of Jump START,STM,and RTS resulted as 0.639,0.660 and 0.711,respectively.The correlation coefficients(rs)between the triage methodologies and ISS score were-0.267,-0.138 and-0.104,respectively.Conclusion Taking ICU acceptance as end point suggests that the value of RTS is better than Jump START,while the correlation between Jump START and ISS score is the highest among the three.Jump START is still recommended as triage methodology for children.

关 键 词：检伤分类方法 Jump START STM RTS ISS评分 

分 类 号：R129[医药卫生—环境卫生学]