A hybrid emergency room (ER) is defined as an emergency unit with four functions—performing resuscitation, computed tomography (CT), surgery, and angiography. However, the safety and efficacy of performing CT in a hybrid ER are unclear in primary surveys. Therefore, this study aimed to evaluate the safety and clinical effects of hybrid ERs. This retrospective observational study used data from the Shimane University Hospital Trauma Database from January 2016 to February 2019. Hospitalized patients with severe trauma and an injury severity score of ≥ 16 were divided into the non-hybrid ER group (n = 134) and the hybrid ER group (n = 145). The time from arrival to CT and interventions and the number of in-hospital survivors, preventable trauma deaths (PTD), and unexpected survivors (US) were assessed in both groups. Further, the amount of blood transfused was compared between the groups using propensity score matching. The time from arrival to CT and interventions was significantly reduced in the hybrid ER group compared to that in the non-hybrid ER group (25 vs. 6 min; p < 0.0001 and 101 vs. 41 min; p = 0.0007, respectively). There was no significant difference in the rate of in-hospital survivors (96.9% vs. 96.3%; p = 0.770), PTD (0% vs. 0%), and US (9.0 vs. 6.2%; p = 0.497) between the groups. The amount of blood transfused was significantly lower in the hybrid ER group than in the non-hybrid ER group (whole blood 14 vs. 8, p = 0.004; red blood cell 6 vs. 2, p = 0.012; fresh frozen plasma 9 vs. 6, p = 0.021). This difference was maintained after propensity score matching (whole blood 28 [10–54] vs. 6 [4–16.5], p = 0.015; RBC 8 [2.75–26.5] vs. 2 [0–8.5], p = 0.020, 18 [5.5–27] vs. 6 [3.5–7.5], p = 0.057). The study results suggest that trauma treatment in a hybrid ER is as safe as conventional treatment performed in a non-hybrid ER. Further, hybrid ERs, which can reduce the time for trauma surveys and treatment, do not require patient transfer and can reduce the amount of blood transfused during resuscitation.

中文翻译：

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混合急诊室减少了严重创伤患者的输血需求

混合急诊室 (ER) 被定义为具有四种功能的急诊室——执行复苏、计算机断层扫描 (CT)、手术和血管造影。然而，在初级调查中尚不清楚在混合 ER 中执行 CT 的安全性和有效性。因此，本研究旨在评估混合 ER 的安全性和临床效果。这项回顾性观察性研究使用了岛根大学医院创伤数据库 2016 年 1 月至 2019 年 2 月的数据。严重创伤且损伤严重程度评分≥16 的住院患者被分为非混合 ER 组（n = 134）和混合ER 组（n = 145）。评估了两组从到达 CT 和干预的时间以及住院幸存者、可预防的创伤死亡 (PTD) 和意外幸存者 (US) 的数量。更远，使用倾向评分匹配比较各组之间的输血量。与非混合 ER 组相比，混合 ER 组从到达 CT 和干预的时间显着减少（分别为 25 与 6 分钟；p < 0.0001 和 101 与 41 分钟；p = 0.0007，分别）。住院存活率（96.9% 对 96.3%；p = 0.770）、PTD（0% 对 0%）和 US（9.0 对 6.2%；p = 0.497）之间没有显着差异组。混合 ER 组的输血量显着低于非混合 ER 组（全血 14 对 8，p = 0.004；红细胞 6 对 2，p = 0.012；新鲜冷冻血浆 9 对. 6，p = 0.021）。这种差异在倾向评分匹配后得以维持（全血 28 [10-54] 与 6 [4-16.5]，p = 0.015；RBC 8 [2.75-26.5] 与 2 [0-8.5]，p = 0。020, 18 [5.5–27] 与 6 [3.5–7.5]，p = 0.057）。研究结果表明，混合 ER 中的创伤治疗与在非混合 ER 中进行的常规治疗一样安全。此外，混合 ER 可以减少创伤调查和治疗的时间，不需要患者转移，并且可以减少复苏期间的输血量。