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吸入伤害严重性评分预测烧伤患者的整体存活率
Ashley N Flinn1, Phillip M Kemp Bohan1, Catherine Rauschendorfer2
1Department of Trauma, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
概括
吸入伤害严重程度评分 (I-ISS) 是唯一一个预测烧伤患者生存率的系统. 重复评估可以提高预测吸入伤害死亡率的准确性.
科学领域:
- 医学研究 医学研究
- 创伤外科手术是什么
- 肺部病理学 肺部病理学
背景情况:
- 吸入伤害在烧伤患者中很常见,增加了发病率和死亡率.
- 现有的吸入伤害评分系统缺乏验证,无法预测患者的结果.
- 准确的生存预测对于管理吸入伤害的烧伤患者至关重要.
研究的目的:
- 评估三个吸入伤害评分系统对患者生存的预测能力.
- 评估不同评分系统在分级吸入伤害方面的一致性.
- 确定最可靠的评分系统来预测烧伤患者的整体存活率.
主要方法:
- 这是一项针对99名被直管烧伤患者的前性观察性研究.
- 纤维光学支气管镜检查在入院后24小时内进行.
- 吸入伤害的分级使用缩写伤害评分 (AIS),吸入伤害严重程度评分 (I-ISS) 和粘膜评分 (MS).
- 使用Krippendorff的alpha (KA) 评估的一致性;通过多变量分析确定的生存关联.
主要成果:
- 对于AIS,I-ISS和MS的入学中位数为2.
- 与幸存者相比,死亡的患者的整体伤害负担更高,I-ISS得分更高.
- 在入院时观察到三个评分系统之间存在强烈的相关性 (KA = 0.85).
- I-ISS是唯一一个独立与整体存活率相关的评分系统 (OR 13.16,P = .02).
结论:
- 吸入伤害严重程度评分 (I-ISS) 有效地预测烧伤患者的整体存活率.
- 由于损伤的进展,缩写伤害评分 (AIS) 和粘膜评分 (MS) 可能不那么可靠.
- 重复的伤害评估可以提高对死亡风险较高的患者的识别.
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