多创伤中的急性胃肠道损伤:特别注意老年患者
Cong Zhang1,2, Teding Chang1,2, Deng Chen1,2
1Department of Trauma Surgery, Emergency Surgery & Surgical Critical, Tongji Trauma Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
International journal of medical sciences
|September 23, 2024
概括
老年多创伤患者经历了急性胃肠道损伤 (AGI) 的高发病率,诸如损伤严重程度得分和乳酸水平等因素预测了风险. AGI在这个脆弱人群中显著增加了死亡率.
科学领域:
- 创伤外科 手术 创伤外科
- 关键护理医学 关键护理医学
- 老年医学 老年医学
背景情况:
- 急性胃肠道损伤 (AGI) 是一种已知的严重病患者的并发症.
- 关于老年多创伤患者的AGI发生率,危险因素和结果的数据有限.
- 老年多创伤患者代表了一个未经研究的人口,具有潜在的独特AGI特征.
研究的目的:
- 调查老年多创伤患者中AGI的发生频率.
- 在这个群体中确定与AGI发展相关的诱导因素.
- 评估AGI老年多创伤患者的临床结果,包括死亡率.
主要方法:
- 追溯性,观察性,多中心研究设计.
- 在两个I级创伤中心 (从2020年7月至2022年4月) 纳入1054名多创伤患者.
- 老年人和年轻患者群体之间的AGI发生率和结果的比较.
主要成果:
- 73.5%的老年多创伤患者发生了AGI.
- 损伤严重性得分 (ISS) 的增加,冲击指数 (SI),血清乳酸盐,IL-6和激活的部分血栓形成时间 (APTT),以及格拉斯哥昏迷量表 (GCS) 的降低,与更高的AGI风险有关.
- 患有AGI的老年患者的28天 (40.4%) 和60天 (61.2%) 死亡率显着更高.
- 在预测28天死亡率方面,AGI等级III-IV表现出高灵敏度 (96%) 和特异性 (87%).
结论:
- 老年多创伤患者面临更高的AGI发病率和更差的预后.
- 在老年多创伤患者中,ISS,GCS,SI,血清乳酸,IL-6和APTT作为AGI的可靠预后标志物.
- 严重的AGI (III-IV级) 是该患者群体死亡率的独立预测因素.
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