[Evolution of the assessment of diagnosis of multiple trauma patients and orientation in emergency care].
Emergency care is estimated on the basis of experience at Tours University Hospital (20,000 emergencies per year). The study deals with adult patients with multiple injuries in relation to the overall activity of the department, from 1981 to 1989. The accuracy of the diagnosis and the severity criteria are essential parameters for an exploitable study. The analysis of the surgical parameters shows an overall increase in the severity of bone and visceral injuries. The overall increase from 157,686 surgical unit codes (proportional to the complexity of the operation) in 1981 to 601,109 in 1988 markedly exceeds the increase in the number of patients, from 16,404 to 22,608. Out of about 4,000 emergent operations per year, 12% involve patients with multiple injuries. The consequence of the fourfold increase in these individual treatments, especially in light surgery and surgery with a stay in hospital not exceeding 24 hours, is a sixfold increase in biological examinations and a threefold increase in radiological examinations. The cost of care in the Emergency Department makes up to 1% of the general budget of the hospital. In order to achieve a valuable control of these structures, a permanent participation of the upstream (SAMU-Emergency Medical Assistance Department) and downstream (specialist departments) medical teams is essential, in order to properly assess the diagnostic and therapeutic performances and to obtain the best possible fit between the complete evaluation of the lesions and the minimum costs.(ABSTRACT TRUNCATED AT 250 WORDS)
Murat
J E
JE
Département d'Urgences de l'Université de Tours.
Huten
N
N
D004630:Emergencies; D004632:Emergency Medical Services / Q000191:economics / Q000458:organization & administration*; D005602:France; D006801:Humans; D009104:Multiple Trauma / Q000175:diagnosis* / Q000601:surgery; D015599:Trauma Severity Indices
Evolution dans l'appréciation du diagnostic des polytraumatisés et orientation des soins en urgence.