创伤性狂犬病:罕见但病态,可能致命,且监测不一致
Thomas Giles1,2, Kate King1,3,2, Simone Meakes3,2
1Discipline of Surgery, School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.
概括
创伤性狂犬病 (TR) 很少见,但与急性损伤 (AKI) 密切相关. 在严重创伤患者中进行标准化监测和肌酸激酶 (CK) 测试可以改善结果并指导未来的研究.
科学领域:
- 创伤护理的护理人员.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 流行病学 流行病学
背景情况:
- 创伤性狂犬病 (TR) 与急性损伤 (AKI) 有关.
- 有限的大规模流行病学数据和指导方针存在TR管理.
- 目前的TR调查和监测实践往往是临时性的.
研究的目的:
- 建立TR的当代流行病学.
- 描述TR调查和监测中的当前做法.
- 为未来关于TR的高质量研究提供数据.
主要方法:
- 对16岁以上的患者进行回顾性队列研究,受伤严重程度评分 (ISS) >12.
- 收集了人口统计数据,生命体征,入院实验室和每日肌酸激酶 (CK) 值.
- 由CK定义的TR>5000IU;次要结局包括AKI,死亡率和器官衰竭.
主要成果:
- 586名患者中有15名 (2.56%) 患有TR.
- TR患者的ISS (中位数为29对18) 和死亡率 (26.7%对8.9%) 较高.
- 九名 (60%) 的TR患者患上了AKI,而整体人群中这一比例为10.8%.
结论:
- 在没有自由查的情况下,TR很少发生,但与AKI密切相关.
- 在高度严重的创伤中,标准化的监测和自由的CK测试可能是合理的.
- 流行病学数据支持定义人口,并为未来的多中心研究提供动力.
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