机制是一个生物变量吗? :对PROPPR试验进行二次分析
Emily W Baird1, Daniel T Lammers1, Russell L Griffin1
1From the Center for Injury Science, University of Alabama at Birmingham, Birmingham, AL.
概括
这项研究发现:1:1:1的复苏策略显著降低了3小时和6小时后重创伤患者的死亡率. 穿透创伤患者在复苏策略中没有显示类似的好处.
科学领域:
- 创伤复苏策略 创伤复苏策略
- 伤害机制对死亡率的影响
- 比较有效性研究比较有效性研究
背景情况:
- 现有研究表明,形和透创伤之间的死亡率差异.
- 这些差异,包括基线和效果大小,往往没有明确考虑.
- 本分析旨在通过伤害机制和复苏来分层比较结果.
研究的目的:
- 根据伤害机制评估基线死亡率的差异.
- 为了比较患者对两种复苏模式的反应:1:1:1和1:1:2比率.
- 为了测试这一假设,和透创伤患者在基线和效果大小上有所不同.
主要方法:
- 实用随机最佳血小板和血比率 (PROPPR) 试验的回顾性审查.
- 在1:1:1或1:1:2复苏下对伤与穿透伤害的死亡结果的分析.
- 后勤回归与一般估计方程调整为年龄,ISS,GCS和脉.
主要成果:
- 总体而言,在形和穿透性伤害之间,24小时死亡率相似 (16.9%对11.8%,P=0.063).
- 1:1:1复苏显著降低了死率在3个和6个小时对于重的受伤患者.
- 对于穿透性伤害或其他时间点,没有观察到死亡率的显著差异.
结论:
- 对于对比复苏策略的重伤害,在3小时后调整后的死亡率中发现了显著的差异.
- 复苏反应可以根据受伤机制而有所不同.
- 具体的干预措施可能会提供更大的好处,这取决于持续创伤的类型.
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