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创伤引起的血结病:患病率和与死亡的关联持续了20年
William Teeter, Matthew D Neal, Joshua B Brown
1Department of Surgery, Kenyatta University, College of Health Sciences, Nairobi, Kenya.
Shock (Augusta, Ga.)
|June 26, 2024
概括
早期创伤引起的凝血病 (eTIC) 仍然普遍存在,并显著增加创伤患者的死亡风险. 尽管在护理方面取得了进展,但eTIC生物标志物在所有伤害严重程度上都强烈预测了糟糕的结果.
科学领域:
- 创伤外科 手术 创伤外科
- 紧急医疗 紧急医疗
- 血液学 血液学 血液学
背景情况:
- 2003年的一项研究发现,28%的患者患有早期创伤诱导凝血病 (eTIC),与8.9%的死亡率有关.
- 在过去的二十年中,在了解和处理eTIC方面取得了重大进展.
研究的目的:
- 评估eTIC目前的流行程度和对创伤患者死亡率的影响.
- 将当代的etic比率和结果与2003年的历史数据进行比较.
主要方法:
- 从2018年到2022年,对20107名成年创伤患者进行了回顾性队列研究.
- 与2003年的历史数据进行比较.
- 使用后勤回归和分类和回归树来分析人口统计,实验室数据,临床结果和死亡率.
主要成果:
- 目前的eTIC流行率为33.4% (32%异常PT,10%异常PTT).
- 在当代队列中,全因死亡率为6.0%.
- 在所有伤害严重程度上,eTIC独立增加了2.1倍的死亡风险 (AUROC 0.932).
结论:
- eTIC仍然是创伤患者死亡率的重要预测因素.
- 即使在现代创伤护理中,etic中的凝血病生物标志物仍然可以很好地预测不良结果.
- eTIC对死亡率的影响很大,特别是在伤害严重程度得分较低的患者中.
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