意外低温对创伤患者的影响:回顾性队列研究
Mozdalefa Azarkane1, Tim W H Rijnhout1, Isa A L van Merwijk1
1Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, the Netherlands.
Injury
|August 10, 2023
概括
低温影响12.6%的严重受伤的创伤患者,增加死亡率和发病率. 关键预测因素包括伤害严重程度,医院前干预和低血压,强调了早期检测和管理的必要性.
科学领域:
- 创伤学 创伤学 创伤学
- 紧急医疗 紧急医疗
- 关键的护理关键的护理
背景情况:
- 低温症显著增加创伤患者的死亡率和发病率.
- 在严重受伤的个体中,低温的发生率可达50%.
- 了解低温的影响对于改善创伤护理结果至关重要.
研究的目的:
- 为了确定严重受伤的创伤患者中低温的发生率.
- 为了确定与抵达医院时低温相关的预测因素.
- 评估低温对患者结果的影响,包括输血需求,死亡率和ICU入院.
主要方法:
- 对创伤患者的回顾性队列研究,创伤严重程度评分 (ISS) ≥16.
- 从荷兰1级创伤中心 (2015-2021) 收集的数据.
- 后勤回归分析用于确定低温和结果之间的关联.
主要成果:
- 在2032名严重受伤的患者中,有12.6%的患者在抵达时体温下降.
- 预测因素包括较高的ISS,医院前输管,椎脊柱固定,冬季,静脉血压<90mmHg,以及格拉斯哥昏迷表≤8.
- 低温独立地与增加的输血需求 (OR 2.68),死亡率 (OR 2.12) 和重症监护室入院 (OR 1.81) 相联系.
结论:
- 低温是12.6%严重受伤的创伤患者的一个重要问题.
- 低温症与更高的输血需求,死亡率和ICU入院有关.
- 伤害严重程度,医院前管理和生理参数预测低温.
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