疾病预防统计学分析方法.docVIP

4.4 Statistical methods: risk-adjusted mortality 4．4统计方法：风险调整的死亡率 A number of different scoring systems exist to help compare injuries between patients in an objective manner. Some of these scoring systems are based on the anatomical nature of the injuries sustained (anatomical scores) and some are based on the physiological status of the patient (physiological scores). The best known and most widely used scoring systems are the Abbreviated Injury Scale (AIS), the Injury Severity Score (ISS), the Glasgow Coma Scale (GCS), the Revised Trauma Score (RTS), the Trauma and Injury and Severity Score (TRISS), and A Severity Characterization of Trauma (ASCOT) (Baker, 1974; Champion, 1989; O’Keefe and Jurkovich, 2001; Association for the Advancement of Automotive Medicine, 2005). A detailed comparison of the scoring systems can be found in Table 18. 有许多不同的评分系统有助于客观地对照病人间的损伤程度。有些评分系统是基于受伤的解剖学特点（解剖学得分），也有些评分系统是基于病人的生理学状况（生理学得分）。最广为人知和广泛使用的评分系统是简略损伤量表（AIS）,损伤严重程度评分（ISS）,格拉斯哥昏迷指数(GCS),修正创伤评分(RTS),创伤损伤严重程度评分（TRISS）,和创伤严重度(ASCOT)(贝克，1974；钱皮恩，1989；奥基夫和尤尔科维奇，2001；汽车事故医学发展协会，2005)。评分系统间的详细比照见表18。 table 16 Causes of errors 表16 导致错误的原因 Diagnostic error 诊断错误 Data are incorrectly perceived. 病情没有被正确理解。 As a result, an incorrect intention is formulated and therefore the wrong action is performed. 因此形成了错误的诊断，从而采取了错误的治疗方法。 Example: Failure to diagnose intra-abdominal haemorrhage, and subsequent delay in operative intervention. 举例：腹内大出血的误诊导致手术治疗的延误。 Intention error 判断错误 Data are correctly perceived. 病情被正确理解了。 Incorrect intention is nonetheless developed and therefore the wrong action is performed. 仍然产生了错误的判断，因此采取了错误的治疗行为。 Example: Awareness of a threatened airway in a hypoxic, head-injured patient, but failure to take steps to clear and establish a secure airway. 举例：意识到导气管对缺氧，头部受伤病人可能造成的威胁，却没有采取措施清除并建立安全的导气管。 Execution error 执行错误 Data are correctly perceived. 病情被正确理解了。 Correct intention is developed. 做出了正确的判断。 Wrong or unintended action is performed. 采取了错误或失误的治疗行为。 Example: Mak