在儿科损伤中保守管理失败的预测因素:国家创伤数据库洞察力
Mann Patel1, Taylor Glassman1, Sathyaprasad Burjonrappa2
1Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA.
Journal of pediatric surgery
|October 29, 2024
概括
儿科损伤的保守管理在4.5%的病例中失败,较高的损伤严重程度得分和等级预测失败. 需要精细的协议,以获得最佳的儿科损伤护理.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 儿科手术 儿科手术
- 创伤外科 手术 创伤外科
背景情况:
- 儿科损伤管理已经进化,常常偏好保守的方法.
- 了解故障率和保守管理的预测因素对于优化结果至关重要.
研究的目的:
- 评估儿童损伤的当代管理策略.
- 确定儿科损伤中保守管理失败的预测因素.
主要方法:
- 国家创伤数据库 (2018-2021) 对儿科损伤患者 (≤18岁) 的分析.
- 将患者分为立即手术,保守和失败的保守管理组.
- 统计分析包括描述性统计,威尔科克森等级总和,奇平方和几率比率.
主要成果:
- 在7266名患者中,95%接受了保守的治疗,失败率为4.5%.
- 较高的伤害严重性评分 (ISS) 和美国创伤外科手术协会 (AAST) 的损伤等级III-V预测了保守的管理失败.
- 与失败的保守管理相比,预先的外科治疗在较低的伤害等级 (I-II) 中显示出更高的切除术率.
结论:
- 儿科损伤的保守管理失败发生在4.5%的病例中.
- 更高的AAST损伤等级和ISS是保守管理失败的重要预测因素.
- 目前的儿科创伤方案需要改进,以改善对损伤的管理.
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