出院后的并发症和创伤性肋骨骨折住院后的随访时间
Taylor N Anderson1,2, Michelle Earley3, Sarah J Rockwood4
1Division of General Surgery, Department of Surgery, Stanford University, Stanford, USA. tand@stanford.edu.
概括
由于创伤性肋骨骨折造成的出院后并发症很少见,大多发生在两周内. 早期的随访可能有利于患者,无论手术或非手术管理.
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
- 整形外科手术 整形外科手术
背景情况:
- 创伤性肋骨骨折是常见的伤害,有可能导致严重的发病率.
- 管理策略范围从非手术护理到肋骨骨折 (SSRF) 的手术稳定.
- 了解出院后的并发症对于优化患者的治疗结果至关重要.
研究的目的:
- 评估创伤性肋骨骨折患者出院后并发症的频率和时间.
- 为了比较操作 (SSRF) 和非操作管理之间的结果.
- 鉴定出院后与不良事件相关的风险因素.
主要方法:
- 在一级创伤中心 (1/2020-12/2021) 住院的成年肋骨骨折患者的回顾性评估.
- 评估结果:与肋骨相关的并发症,肺炎,新发的阿片类药物或酒精使用障碍以及所有原因的死亡率.
- 精细和灰色的危险模型用于分析竞争风险,死亡作为竞争事件.
主要成果:
- 在976名患者中,93%接受了非手术治疗,7%接受了SSRF.
- 与肋骨相关的并发症很少发生 (1%的非手术 vs. 6%的SSRF).
- 在这两组中,肺炎,新发性物质使用障碍和死亡率都很低,SSRF显示出较低死亡率的趋势.
结论:
- 创伤性肋骨骨折后的出院后并发症很少见,但主要发生在前两周内.
- 这些发现支持对肋骨骨折患者进行集中早期随访的考虑.
- 管理策略 (手术与非手术) 并没有显著影响整体下降的退院后并发症率.
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