在重创伤患者的肋骨骨折后延迟血胸再入院
Joep J J Ouwerkerk1,2, Dias Argandykov1, Anthony Gerban1
1Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
肋骨骨折后延迟血胸 (DHTX) 再接收不常见,但与特定的风险因素有关. 识别这些因素对于预防再入院和改善患者在创伤性肋骨损伤后的结果至关重要.
科学领域:
- 创伤外科 手术 创伤外科
- 胸部外科手术 胸部外科手术
- 关键护理医学 关键护理医学
背景情况:
- 肋骨骨折是最常见的创伤性损伤,血胸发生在10-37%的病例中.
- 延迟性血胸 (DHTX) 是一种研究较少的并发症,涉及到腔内血液的积累.
- 在初始肋骨骨折治疗后,关于DHTX再接收的风险因素的文献有限.
研究的目的:
- 在30天内确定与DHTX再接收相关的潜在风险因素.
- 检查DHTX再入院的描述性临床和财务特征.
- 为更好地了解肋骨骨折后DHTX再接收模式做出贡献.
主要方法:
- 使用了2016-2019年国家再接收数据库 (NRD).
- 包括接受了突发创伤性肋骨骨折的患者.
- 在肋骨骨折入院后30天内使用ICD-10代码对血胸部进行识别的DHTX再入院.
- 进行单变量和多变量分析以确定风险因素.
主要成果:
- 总共有242,071名患者被分析; 635人经历了DHTX再入院.
- 在初次入院期间诊断出血胸病显著增加了DHTX再入院几率 (OR 7.43).
- 再入院期间常见的并发症包括急性呼吸衰竭 (16.9%),败血症 (6.9%) 和血症 (4.3%).
- 治疗包括肺部排水 (62.2%) 和VATS疏散 (10.1%).
结论:
- 肋骨骨折后的DHTX再接收很少发生,但与可识别的风险因素有关.
- 多变量分析揭示了DHTX再接收的特定风险和保护因素.
- 需要进一步的研究来制定查和预防DHTX再接收的策略.
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