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在创伤患者中输管设置和死亡率进行出血控制手术:倾向性得分匹配分析
Tomer Talmy1,2,3,4, Irina Radomislensky4, Isaac Brzezinski Sinai1
1From the Division of Anesthesia, Intensive Care & Pain Management, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
Anesthesia and analgesia
|May 16, 2025
概括
在重大创伤患者的急诊室输管与更高的住院死亡率无关. 经过损伤严重程度和冲击的调整后,结果与手术室输管治疗相似.
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:
- 对创伤患者来说,内管道输入至关重要,但可能导致不稳定.
- 之前的研究表明,急诊室 (ED) 输管与手术室 (OR) 输管的死亡率更高.
- 对各种创伤群体的适用性仍然不清楚.
研究的目的:
- 调查ED输管与重创患者住院死亡率之间的关联.
- 为了比较ED输管与OR输管在需要紧急手术的创伤患者的结果.
主要方法:
- 对以色列国家创伤登记处 (2016-2023) 对需要进行出血控制手术的重大创伤患者 (ISS ≥16) 的分析.
- 在ED和OR输管组之间的医院死亡率的比较.
- 使用多变量逻辑回归和倾向得分匹配以控制混因子.
主要成果:
- 在975名患者中,48.2%接受了ED输管;这些患者的损伤严重程度和休克程度更高.
- 未经调整的分析显示,ED输管治疗的死亡率较高 (22.6%与8.5%相比).
- 在调整和倾向得分匹配后,在住院死亡率上没有发现显著差异 (12.5%与12.2%). ED输管与ICU入院的增加有关.
结论:
- 在接受紧急手术的重大创伤患者中,ED输管并没有独立地与医院内死亡率的增加有关.
- 研究结果表明,ED输管在严重受伤的患者中更常见,但其对死亡率的直接影响尚未确定.
- 需要进一步的前性研究来澄清ED输管在创伤护理中的作用.
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