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纤维素度对创伤性大规模出血的静血效应:一种倾向性得分匹配研究
Yoonjung Heo1,2, Sung Wook Chang3, Seok Won Lee2
1Division of Surgery, Department of Medicine, Dankook University Graduate School, Cheonan, Chungnam, Korea (the Republic of).
Trauma surgery & acute care open
|February 1, 2024
概括
纤维素缩剂 (FC) 在创伤患者中没有改善大量出血的生存率. 然而,在这些关键病例中,FC的使用与血液产品输血量减少有关.
科学领域:
- 创伤和紧急医疗医学
- 血液学 血液学 血液学
- 关键的护理关键的护理
背景情况:
- 创伤诱导的凝血病是大规模输血协议的一个重大挑战.
- 纤维素缩剂 (FC) 用于治疗凝血病,但对其对生存的影响的证据有限.
- 高层证据很少,需要进一步调查FC的有效性.
研究的目的:
- 为了研究纤维素缩物 (FC) 对因创伤而遭受大规模出血的患者的死亡率的静血效应.
- 评估FC的管理是否影响创伤环境中的生存率.
主要方法:
- 在一级创伤中心 (2015-2022) 接受大规模输血的839名患者的回顾性分析.
- 排除特定的患者群体 (转移,到达时死亡,严重脑损伤,儿科).
- 1:2倾向性得分匹配,比较FC (+) 和FC (-) 组 (n=68与n=437),以评估死亡率和输血量.
主要成果:
- 在不同时间点 (住院,24小时,48小时,7天) 给予纤维素缩剂并没有显著降低或预测死亡率.
- 与FC (+) 组相比,FC (-) 组获得的红细胞,新鲜冷血和血小板数量显著增加.
- 倾向性得分匹配控制生命体征,损伤特征,医院前时间,REBOA和血液气体分析.
结论:
- 在创伤性大规模出血中使用纤维素缩剂在本研究中没有显示出生存益处.
- FC的使用与其他血液制品的输血需求减少有关.
- 未来的研究应该探索涉及FC的个性化,目标导向的输血策略,用于大规模出血管理.
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