生理学参数和放射学发现可以预测肺部并发症,并指导创伤性肋骨骨折的管理
Abdul Hafiz Al Tannir1, Courtney J Pokrzywa1, Christopher Dodgion1
1Department of Surgery, Division of Trauma & Critical Care Surgery, Medical College of Wisconsin, Milwaukee, WI, USA.
生命能力 (VC) 和RibScore独立预测肋骨骨折患者的肺部并发症. 没有一种方法被证明是优越的,这表明两者都对风险评估有价值.
科学领域:
- 创伤外科 手术 创伤外科
- 肺部医学 肺部医学
- 关键的护理关键的护理
背景情况:
- 创伤性肋骨骨折带有显著的发病率,肺部并发症 (PC) 构成主要风险.
- 早期识别易受PC感染的患者对于优化管理和减少重症监护室 (ICU) 入院至关重要.
研究的目的:
- 评估和比较生命能力 (VC) 测量的预测能力与肋骨骨折患者PC的入院放射学发现 (RibScore).
主要方法:
- 在2015年至2018年期间,654名患有创伤性肋骨骨折的成年患者被录取到一级创伤中心的回顾性审查.
- 根据PC的发展 (肺炎,计划外的输管,计划外的ICU转移或气管切除术) 患者被分层.
- 用多变量逻辑回归和歧视分析来确定PC的预测因素.
主要成果:
- 肺部并发症发生在5.5%的患者中,与年龄较大,受伤严重程度得分 (ISS) 高,需要进行管胸切除术有关.
- 在多个时间点下降的生命能力 (VC ≤30%) 和RibScore ≥2是PC的显著独立预测因素.
- 第二天的VC显示了最高的预测准确性 (ROC曲线下的面积:0.81),与RibScore.com的表现相当.
结论:
- 活力容量 (VC) 和RibScore都是创伤性肋骨骨折患者肺部并发症的独立预测指标.
- 没有发现VC在预测PC方面优于RibScore.
- 建议进行进一步的前性研究来验证这些发现.
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