Hemorrhage control is a time-critical task, and recent studies have demonstrated that a shorter time to definitive care is positively associated with patient survival and functional outcomes. The concept of direct transport to the operating room was proposed in the 1960s to reduce treatment time. Some trauma centers have developed protocols for direct-to-operating room resuscitation (DOR) programs. Moreover, few studies have reported the clinical outcomes of DOR in patients with trauma; however, their clinical effect in improving the efficiency and quality of care remains unclear. In this systematic review, we aimed to consolidate all published studies reporting the effect of DOR on severe trauma and evaluate its utility. The PubMed, EMBASE, and Cochrane databases were searched from inception to April 2023, to identify all articles published in English that reported the effect of direct-to-operating room trauma resuscitation for severe trauma. The articles were reviewed as references of interest. We reviewed six studies reporting the clinical effect of operating room trauma resuscitation. A total of 3232 patients were identified. Five studies compared the actual mortality with the predicted mortality using the trauma score and injury severity score, while one study compared mortality using propensity matching. Four studies reported that the actual survival rate for overall injuries was better than the predicted survival rate, whereas two studies reported no difference. Some studies performed subgroup analyses. Two studies showed that the survival rate for penetrating injuries was better than the predicted survival rate, and one showed that the survival rate for blunt injuries was better than the predicted survival rate. Five studies reported the time to surgical intervention, which was within 30 min. Two studies time-compared surgical intervention, which was shorter in patients who underwent DOR. Implementing DOR is likely to have a beneficial effect on mortality and can facilitate rapid intervention in patients with severe shock. Future studies, possibly clinical trials, are needed to ensure a proper comparison of the efficiency.

中文翻译：

---

直接进入手术室创伤复苏的功效：系统评价


出血控制是一项时间紧迫的任务，最近的研究表明，更短的最终护理时间与患者的生存和功能结果呈正相关。直接转运至手术室的概念于20世纪60年代提出，以减少治疗时间。一些创伤中心已经制定了直接手术室复苏 (DOR) 计划的方案。此外，很少有研究报道创伤患者 DOR 的临床结果。然而，它们在提高护理效率和质量方面的临床效果仍不清楚。在本次系统综述中，我们旨在整合所有已发表的报告 DOR 对严重创伤的影响的研究，并评估其实用性。对 PubMed、EMBASE 和 Cochrane 数据库进行了检索，从最初到 2023 年 4 月，以找出所有以英文发表的报告直接进入手术室创伤复苏对严重创伤的影响的文章。这些文章被视为感兴趣的参考文献。我们回顾了六项报告手术室创伤复苏临床效果的研究。总共确定了 3232 名患者。五项研究使用创伤评分和伤害严重程度评分比较了实际死亡率与预测死亡率，而一项研究则使用倾向匹配比较了死亡率。四项研究报告称，总体损伤的实际生存率优于预测生存率，而两项研究报告没有差异。一些研究进行了亚组分析。两项研究表明，穿透伤的生存率优于预测的生存率，一项研究表明，钝性损伤的生存率优于预测的生存率。 五项研究报告了手术干预的时间，在 30 分钟内。两项研究比较了手术干预的时间，接受 DOR 的患者的手术干预时间较短。实施 DOR 可能会对死亡率产生有益影响，并有助于对严重休克患者进行快速干预。需要未来的研究，可能是临床试验，以确保正确比较效率。