现代战争中肢体截肢的危险因素创伤:新的视角
Shachar Shapira1, Sharon Goldman, Adi Givon
1From the Israel Defense Forces, Medical Corps, Kiryat Ono (Shapira, and Epstein), the Faculty of Medicine, The Hebrew University, Jerusalem (Shapira), the Sheba Medical Center, Tel Hashomer, Ramat Gan (Shapira), the Israel National Center for Trauma and Emergency Medicine Research, Gertner Institute of Epidemiology and Health Policy Research, Sheba Medical Center, Ramat Gan (Goldman, Givon, and Katorza), the Arrow Program for Medical Research Education, Chaim Sheba Medical Center, Tel-Hashomer, Ramat Gan (Katorza), the Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv (Katorza, Dudkiewicz, and Prat), the Rehabilitation Division, Sheba Medical Center, Tel Hashomer, Ramat Gan (Dudkiewicz), the Critical Care Division, Rambam Health Care Campus, Haifa (Epstein), the Ruth and Bruce Rappaport Faculty of Medicine, Technion, Haifa (Epstein), and the Department of Orthopaedic Surgery, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel (Prat).
肢体截肢在现代冲突中是一个重大挑战,爆炸伤害和多创伤的风险越来越高. 了解这些因素对于改善严重受伤的战斗人员的治疗结果至关重要.
科学领域:
- 创伤外科 手术 创伤外科
- 军事医学 军事医学
- 整形外科 整形外科 整形外科
背景情况:
- 肢体创伤在现代冲突中很常见,导致肢体截肢率很高.
- 截肢为幸存者和医疗保健系统带来了重大挑战.
研究的目的:
- 确定2023年以色列冲突期间严重肢体创伤的患者肢体截肢的发生率,特征和危险因素.
主要方法:
- 全国范围的回顾性队列研究使用以色列国家创伤登记处 (10月7日至2023年12月31日).
- 包括严重四肢损伤的患者 (缩写损伤得分≥3).
- 将截肢者与非截肢者进行比较;使用多变量后勤回归来确定风险因素.
主要成果:
- 在451名严重肢体损伤的患者中,11.5% (52) 进行了截肢.
- 截肢者更有可能遭受爆炸伤害 (76.9%),受伤严重程度得分高 (ISS ≥16) (75.0%) 和多创伤 (46.1%).
- 截肢的独立风险因素包括爆炸 (aOR 9.74),断层切割 (aOR 8.51) 和多创伤 (aOR 1.98).
结论:
- 冲突中截肢率的上升与先进武器和更好的生存率有关.
- 患有弹性损伤,多创伤或需要切的患者面临截肢风险升高的风险.
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