Journal of Peking University(Health Sciences) >
Application of multidisciplinary team (MDT) in the treatment of severe trauma
Received date: 2019-08-14
Online published: 2020-04-18
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)
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
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 . Application of multidisciplinary team (MDT) in the treatment of severe trauma[J]. Journal of Peking University(Health Sciences), 2020 , 52(2) : 298 -301 . DOI: 10.19723/j.issn.1671-167X.2020.02.017
| [1] | 王天兵, 李明, 杜哲 , 等. 创伤救治中心建设中的医疗质量控制[J]. 中华创伤杂志, 2019,35(3):212-215. |
| [2] | Mercer SJ, Kingston EV, Jones CPL . The trauma call[J]. BMJ, 2018,361:k2272. |
| [3] | 唐华民 . 创伤救治"黄金 1h": 美国创伤系统介绍[J]. 创伤外科杂志, 2017,19(8):638-640. |
| [4] | 胡培阳, 张连阳 . 综合性医院创伤救治多学科团队的建设和维护[J]. 创伤外科杂志, 2018,20(9):719-720. |
| [5] | 都定元, 王建柏 . 中国创伤外科发展现状与展望[J]. 创伤外科杂志, 2018,20(3):161-165. |
| [6] | 邓进, 张连阳 . 我国创伤救治中心建设的困境与对策[J]. 中华灾害救援医学, 2017,5(8):464-466. |
| [7] | 邓鹏, 陈建红, 周祥军 , 等. 县市级创伤救治中心 MDT 模式对提高重症创伤患者生存率的研究[J]. 现代医学与健康研究, 2018,2(16):163-165. |
| [8] | Long AM, Lefebvre CM, Masneri DA , et al. The golden opportunity: multidisciplinary simulation training improves trauma team efficiency[J]. J Surg Educ, 2019,76(4):1116-1121. |
| [9] | 寇玉辉, 殷晓峰, 王天兵 , 等. 严重创伤救治规范的研究与推广[J]. 北京大学学报(医学版), 2015,47(2):207-210. |
/
| 〈 |
|
〉 |