Quality improvement of trauma care: an innovative approach by health services research

2018 Fiscal Year Final Research Report

• Project/Area Number: 16K15388
• Research Category: Grant-in-Aid for Challenging Exploratory Research
• Allocation Type: Multi-year Fund
• Research Field: Medical and hospital managemen
• Research Institution: University of Tsukuba
• Principal Investigator: Abe Toshikazu 筑波大学, 医学医療系, 客員教授 (70633973)
• Co-Investigator(Kenkyū-buntansha): 田宮 菜奈子 筑波大学, 医学医療系, 教授 (20236748)
• Project Period (FY): 2016-04-01 – 2019-03-31
• Keywords: 外傷 / ヘルスサービスリサーチ

Outline of Final Research Achievements

We conducted health services researches of trauma care using data of Japan Trauma Data Bank. We described a trend of trauma care and outcomes during 10 years. We also reported the descriptive epidemiology of pediatric trauma, which has been little information. In regard to prehospital care, we evaluated not only helicopters with physicians but also ambulances with physicians, which was limited information and effectiveness. We also investigated the use of whole-body CT, which is a trend in trauma care. In regard to resuscitation and treatments, we demonstrated the effectiveness of the Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA), which has been recently introduced. We also reported limitations of tracheostomy, which is one of the classic resuscitation methods, and problems of using catecholamine. All of them were published mainly on major journals in the field of emergency and critical care medicine.

Free Research Field

Emergency Medicine

Academic Significance and Societal Importance of the Research Achievements

外傷は若年の主な死因であり予後も悪い。しかし、未だ予後を劇的に改善させる医療手段は見つかっていない。我々は既存の医療サービスが外傷患者の予後の改善にある程度寄与すると考えた。つまり、外傷の予後が大きく改善していない理由として医療が本当に必要な時に必要な方法で必要としている人に確かにサービスとして常に届けられていない可能性がある。
研究代表者が調査・解析し、報告した項目は全て現在、外傷診療で当たり前に行われていることである。当たり前の診療にも良し悪し、改善点があり、今回の研究を用いて、もう一度見直しことができた。今後の外傷診療の診療の質の改善の礎になる研究となった。