预测出血创伤患者的临界管理门.
Kevin Durr1,2, Krishan Yadav3,4, Michael Ho3
1Department of Emergency Medicine, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada. kedurr@toh.ca.
CJEM
|September 29, 2024
概括
早期识别需要血液的创伤患者至关重要. 像低血压和GCS得分这样的关键指标可以预测需要关键血液产品的需要,减少可预防的死亡.
科学领域:
- 创伤外科 手术 创伤外科
- 紧急医疗 紧急医疗
- 关键的护理关键的护理
背景情况:
- 出血性伤害是可预防的创伤死亡的主要原因.
- 及时识别和管理出血对于患者的生存至关重要.
研究的目的:
- 为了确定患者在急诊室到达时可用的变量,预测需要进行关键血液产品的必要性.
- 改善创伤患者严重出血的早期识别.
主要方法:
- 回顾性创伤注册表审查 (2016年9月 - 2020年3月).
- 在一级创伤中心对创伤小组激活的分析.
- 多变量逻辑回归用于识别关键血液管理的预测因素.
主要成果:
- 评估了762名患者;10.2%的患者达到关键的管理值.
- 四个变量预测了临界管理:SBP ≤90 mmHg,GCS ≤8,HR ≥100 bpm,RR ≥20 bpm.
- 临界管理的中位时间为28.9分钟.
结论:
- 系统血压≤90mmHg,格拉斯哥昏迷表≤8,心率≥100bpm,呼吸率≥20bpm是关键预测因素.
- 医生应考虑立即订购血液制品,为患者呈现这些指标.
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