最初血液动力学稳定的儿科患者的结局 胸部创伤 接受急诊室胸切除术的儿科患者
Hazem Nasef1, Sanjan Kumar, Samuel Baum
1Author Affiliations: NOVA Southeastern University, Kiran Patel College of Allopathic Medicine, Fort Lauderdale, Florida (Mr Nasef); University of Central Florida College of Medicine, Orlando, Florida (Mr Kumar); Louisiana State University Health Sciences Center, New Orleans, Louisiana (Mr Baum); William Carey University College of Osteopathic Medicine, Hattiesburg, Mississippi (Mrs Hernandez, Kumar); NOVA Southeastern University, Kiran Patel College of Osteopathic Medicine, Fort Lauderdale, Florida (Mr Awan); Department of Pediatric Surgery, Arnold Palmer Children's Hospital, Orlando Health, Orlando, Florida (Dr Plumley); Department of Surgical Education, Orlando Regional Medical Center, Orlando, Florida (Drs Plumley, Elkbuli); and Department of Surgery, Division of Trauma and Surgical Critical Care, Orlando Regional Medical Center, Orlando, Florida (Dr Elkbuli).
在儿科创伤中,急诊室胸切除术 (EDT) 显示的生存率很低. 这项研究发现,在联合成人/儿童创伤中心接受EDT的最初稳定的儿科患者的死亡率与仅为成人创伤中心的死亡率相似.
科学领域:
- 创伤外科 手术 创伤外科
- 儿科重症监护中心儿童重症监护中心
- 紧急医疗 紧急医疗
背景情况:
- 在儿科胸部创伤中,复苏性胸切除术的生存率很低 (3.4%).
- 在这种新出现的过程中,了解高死亡率机制至关重要.
研究的目的:
- 评估血液动力学稳定的儿科患者接受急诊室胸切除术 (EDT) 的临床结果.
- 为了比较儿科创伤中心 (PTC),联合成人/PTC (CTC) 和仅供成人使用的创伤中心 (ATC) 的结果.
主要方法:
- 美国外科医生学院创伤质量改善计划数据库 (2017-2021) 的回顾性队列分析.
- 包括患有中度至重度胸部创伤 (AIS胸部>2) 的儿科患者 (<18岁),接受EDT.
- 主要结局:根据创伤中心类型分层的死亡率 (ED,24小时,住院).
主要成果:
- 分析了314名患者:219人 (69.7%) 在ATC,77人 (24.5%) 在CTC,18人 (5.7%) 在PTC.
- 在CTC与ATC的透伤害24小时死亡率没有显著差异 (OR 0.02,p=0.501).
- 在CTC与ATC的形伤害24小时死亡率没有显著差异 (OR 0.26,p=0.440).
结论:
- 对于血液动力学稳定的儿科创伤患者,胸部损伤需要EDT,在CTC的治疗与在ATC治疗的可比死亡率有关.
- 这些发现表明,联合中心可以有效地管理这些关键病例.
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