在格拉斯哥昏迷尺度得分为8或更少的创伤后输管和住院死亡率-A队列研究
Kapil Dev Soni1, Varun Bansal2, Monty Khajanchi2
1Critical and Intensive Care, JPN Apex Trauma Centre, AIIMS, New Delhi, India.
The Journal of surgical research
|May 18, 2024
概括
格拉斯哥昏迷量表 (GCS) 分数≤8的创伤患者的早期输管治疗没有降低住院死亡率. 这一发现建议重新考虑早期输管协议,以优化低收入和中等收入国家的资源使用.
科学领域:
- 紧急医疗 紧急医疗
- 创伤外科 手术 创伤外科
- 关键的护理关键的护理
背景情况:
- 创伤学会经常建议在格拉斯哥昏迷表 (GCS) 分数 ≤8.8 的患者进行早期输管治疗.
- 这一建议缺乏强有力的支持证据.
- 这项研究调查了印度创伤患者早期输内管和死亡率之间的关联.
研究的目的:
- 检查到达1小时内输管与创伤患者30天住院死亡率之间的关联,创伤患者的GCS得分≤8.8.
- 评估早期输内管治疗对特定印度创伤登记处患者结果的影响.
主要方法:
- 对GCS ≤8的患者进行比较分析,分为早期输管 (1小时内) 和非早期输管组.
- 采用多变量回归和倾向得分匹配的分析.
- 进行了子组和灵敏度分析,以评估研究结果的可靠性.
主要成果:
- 在GCS ≤8的3476名患者中,48.1%的患者在1小时内被直管.
- 在早期输入管和非早期输入管组之间没有观察到30天住院死亡率的显著差异 (OR=1.2,P=0.467).
- 早期输内管与更长的通风,ICU住院和住院时间有关.
结论:
- 对于GCS ≤8的重大创伤患者,在1小时内输管并没有与减少住院死亡率有关.
- 这项研究表明,需要重新审视严重受伤患者早期输内管道的指示和益处.
- 调查结果强调了在低收入和中等收入国家 (LMICs) 优化资源利用的重要性.
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