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[BMJ圣诞特刊2018]:从飞机上跳下时使用降落伞预防死亡及严重创伤:随机对照试验
2018年12月25日 时讯速递, 进展交流 暂无评论

Research Christmas 2018: Look Before You Leap

Parachute use to prevent death and major trauma when jumping from aircraft: randomized controlled trial

Robert W Yeh, Linda R Valsdottir, Michael W Yeh, et al

BMJ 2018; 363 doi: https://doi.org/10.1136/bmj.k5094 (Published 13 December 2018)

Cite this as: BMJ 2018;363:k5094

Abstract

Objective 目的

To determine if using a parachute prevents death or major traumatic injury when jumping from an aircraft.

确定从飞机上跳下时使用降落伞能否预防死亡或重度颅脑损伤

Design 设计

Randomized controlled trial.

随机对照试验

Setting 场景

Private or commercial aircraft between September 2017 and August 2018.

2017年9月至2018年8月间私人或商用飞机

Participants 参加人员

92 aircraft passengers aged 18 and over were screened for participation. 23 agreed to be enrolled and were randomized.

对92名年龄18岁以上的乘客进行了筛查。23人同意入选并接受随机分组。

Intervention 干预措施

Jumping from an aircraft (airplane or helicopter) with a parachute versus an empty backpack (unblinded).

佩戴降落伞或空伞包(未设盲)从飞机(固定翼飞机或直升飞机)上跳下

Main outcome measures 主要预后指标

Composite of death or major traumatic injury (defined by an Injury Severity Score over 15) upon impact with the ground measured immediately after landing.

包括死亡或严重创伤(定义为创伤严重程度评分超过15分)在内的复合终点,在着陆后立即测定

Results 结果

Parachute use did not significantly reduce death or major injury (0% for parachute v 0% for control; P>0.9). This finding was consistent across multiple subgroups. Compared with individuals screened but not enrolled, participants included in the study were on aircraft at significantly lower altitude (mean of 0.6 m for participants v mean of 9146 m for non-participants; P<0.001) and lower velocity (mean of 0 km/h v mean of 800 km/h; P<0.001).

使用降落伞不能显著减少死亡或严重创伤(降落伞组0% vs. 对照组0%;P>0.9)。上述结果在多个亚组分析中一致。研究受试者在飞机上的高度(受试者平均为0.6 m vs. 非受试者9146 m;P<0.001)和速度(平均0 km/h vs. 平均800 km/h;P<0.001)显著低于接受筛查但未入选研究的人。

Conclusions 结论

Parachute use did not reduce death or major traumatic injury when jumping from aircraft in the first randomized evaluation of this intervention. However, the trial was only able to enroll participants on small stationary aircraft on the ground, suggesting cautious extrapolation to high altitude jumps. When beliefs regarding the effectiveness of an intervention exist in the community, randomized trials might selectively enroll individuals with a lower perceived likelihood of benefit, thus diminishing the applicability of the results to clinical practice.

这是第一项随机评估降落伞效果的临床研究,结果显示,跳下飞机时使用降落伞不能减少死亡或严重创伤。然而,研究仅在使用停在地面的小型飞机时入选受试者,提示应谨慎推广到高空跳下的情况。当人们相信某种干预措施的效果时,随机试验仅能选择性入选受益可能性极低的人群,从而影响了结果在临床工作中实施的可能性。

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