连续性热素是否预测了创伤患者在地面上跌倒后需要进行心脏评估的需要?
Alyssa R Bellini1, James T Ross1,2, Madelyn Larson3
1Department of Surgery, University of California Davis Medical Center, Sacramento, California, USA.
Trauma surgery & acute care open
|June 4, 2024
概括
创伤患者在摔倒后的初始托罗邦尼T水平可以预测心脏问题,但连续测试几乎没有临床价值. 对于初始热素T的门>50 ng/L可能会优化心脏工作并降低成本.
科学领域:
- 紧急医疗 紧急医疗
- 心脏病学 心脏病学
- 创伤护理 创伤护理
背景情况:
- 热素T测试是创伤患者经历地面水平跌倒的标准,以检测心脏的原因.
- 连续激素测试通常在水平达到峰值之前进行,但高灵敏度可能导致临床上无关紧要的重复测试.
研究的目的:
- 评估连续素T测量对预测创伤患者在地面下跌后需要进一步心脏检查的有用性.
- 确定最佳的托罗邦素T值,以指导该患者群体的心脏评估.
主要方法:
- 在2021年1月1日至2021年12月31日期间,因地面跌倒而导致的成人创伤激活的回顾性审查.
- 纳入标准:血液动力学稳定,神经学完好无损的患者 (GCS 15) 具有初始的托洛T抽取.
- 评估结果:心脏病咨询,入院,门诊随访,干预和住院死亡率.
主要成果:
- 在560名患者中,58%的患者进行了第二次托罗邦素T抽取,29%的患者进行了第三次抽取. 最初的托罗邦尼T水平与心脏病咨询,心脏病入院,随访和死亡率有显著的相关性.
- 从第一次测试到第二次测试时,托罗邦尼T的增加与不良结果无关.
- >50 ng/L的托罗邦素T值对进一步的心脏评估具有重要意义,而>90 ng/L也预测了住院死亡率.
结论:
- 初始的托罗邦尼T水平对于在创伤患者中识别心脏病后的心脏病非常有价值.
- 连续的托罗邦尼T测试似乎具有有限的临床价值.
- 实施50 ng/L以上的初始热素T值可以提高临床效用并减少不必要的医疗保健成本.
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