延迟输管对患者的治疗结果和资源利用的影响 维持多个肋骨骨折的患者
Junsik Kwon1,2, Bishoy Zakhary1, Navpreet Dhillon1,3
1Comparative Effectiveness and Clinical Outcomes Research Center - CECORC, Riverside University Health System, Moreno Valley, CA, USA.
对于多重肋骨骨折的患者来说,延迟输管与明显更糟糕的结果有关,包括更高的死亡率和增加的并发症. 在这些关键病例中,早期输管策略对于改善患者的生存和康复至关重要.
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
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 多重肋骨骨折往往需要机械通风,因为呼吸不足.
- 在这些患者中,输管的时间是影响结果的关键因素.
研究的目的:
- 为了研究延迟输管与多重肋骨骨折的成年患者的患者结果之间的关联.
- 为了比较早期与延迟的输内管治疗策略,关于死亡率,并发症和资源利用.
主要方法:
- 对创伤质量改善计划数据库 (2017-2021) 的分析.
- 在入院后进行早期 (24小时以下) 与延迟 (24小时以上) 的输管治疗的患者的比较.
- 使用治疗权重和后勤回归的逆概率用于调整后果分析.
主要成果:
- 延迟输管与更高的住院死亡率 (19.7%与13.7%) 和ARDS,肺栓塞,严重败血症和急性损伤的增加率有关.
- 延迟输管的患者在医院和ICU停留时间更长,机械通风持续时间增加.
- 延迟输管独立增加了死亡几率 (OR 1.584).
结论:
- 多重肋骨骨折患者的延迟输管与不良临床结果和资源利用率增加有关.
- 早期识别有风险的患者和考虑早期输内管是改善生存和减少并发症的关键.
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