Journal of Peking University (Health Sciences) ›› 2020, Vol. 52 ›› Issue (2): 298-301. doi: 10.19723/j.issn.1671-167X.2020.02.017

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Application of multidisciplinary team (MDT) in the treatment of severe trauma

Zhe DU,Wei HUANG,Zhi-wei WANG,Jing ZHOU,Jian XIONG,Ming LI,Peng ZHANG,Zhong-di LIU,Feng-xue ZHU,Chuan-lin WANG,Bao-guo JIANG,Tian-bing WANG()   

  1. Trauma Center, Peking University People's Hospital, National Center for Trauma Medicine, Beijing 100044, China
  • Received:2019-08-14 Online:2020-04-18 Published:2020-04-18
  • Contact: Tian-bing WANG E-mail:wangtianbing@pkuph.edu.cn
  • Supported by:
    Supported by Subproject of 2022 Science and Technology Winter Olympic Project(2018YFF0301103);Peking University People’s Hospital Scientific Research Development Funds(RD2019-02)

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Abstract:

Objective: To explore the effect of multi-disciplinary team (MDT) in general hospitals on severe trauma patients.Methods: This study reviewed the treatment of patients with severe trauma in trauma center of Peking University People's Hospital from March 2017 to April 2019. The baseline information: the patients' gender, age, injury mechanism, etc.; the start indicators: the Glasgow coma scale (GCS), trauma index (TI), injury severity score (ISS); the start related indicators: time for activation, time for MDT to arrive, time for CT scan, time for damage control surgery; patient treatment and prognosis: ICU (intensive care unit) length of stay, number of cured and discharged patients, number of dead cases, number of patients transferred to rehabilitation hospital, were all analyzed. It discussed the composition of MDT, the initiation scheme, the indicators of initiation of MDT for severe trauma, and analyzed the correlation between the application of MDT and the prognosis of patients.Results: From March 2017 to April 2019, 112 trauma patients were treated by MDT in Peking University People's Hospital. There were 69 males and 43 females. The minimum age was 15 years, the maximum age was 89 years, most of them were 36-55 years old. The main injury mechanism was traffic accident injury. The GCS, TI, ISS were 13.0±2.9, 13.0±2.8, and 21.5±11.9, respectively. It took 3.7±0.8 minutes to start the call, 6.1±0.9 minutes for MDT personnel to arrive at the emergency rescue area, 23.8±3.0 minutes for fast CT and 92.6±15.4 minutes for injury control operation. All the hospitalized patients were treated effectively. ICU (Intensive care unit) hospitalization time was 12.6±6.7 days. 55 discharged patients were cured, 5 died (1 died of hemorrhagic shock, 4 died of severe brain injury) and 52 transferred to rehabilitation hospital.Conclusion: The treatment of severe trauma patients by MDT in trauma center of general hospitals can greatly improve the ability and level of treatment of severe trauma patients, make up for the lack of treatment of severe trauma especially multiple trauma patients in large general hospitals, and improve the treatment effect of severe trauma patients. It provides a reference model for large general hospitals to treat patients with severe trauma and multiple trauma and for the construction of trauma centers.

Key words: Trauma center, Multidisciplinary team (MDT), Model, Severe trauma, Application

CLC Number: 

  • R649.9

Table 1

The baseline characteristics of severe trauma patients"

Items Number
Gender
Male 69
Female 43
Age
15-35 12
36-55 48
56-75 39
>75 13
Mechanics of injury
Traffic accidents 52
Fall 29
Explosion, crush injury 19
Others 12

Table 2

Evaluation of related indicators after start-up of MDT"

Indicators Data
Activation indicators
GCS 13.0±2.9
TI 13.0±3.8
ISS 21.5±11.9
Activation related indicators/min
Time for activation 3.7±0.8
Time for MDT to arrive 6.1±0.9
Time for CT scan 23.8±3.0
Time for damage control surgery 92.6±15.4
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