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对老年创伤的输血徒劳性值,有或没有同时发生的创伤性脑损伤
Nikita Nunes1, Hazem Nasef, Samuel Baum
1Author Affiliations: Kiran Patel College of Osteopathic Medicine, NOVA Southeastern University, Fort Lauderdale, Florida (Mrs Nunes, Ms Amin, and Ms Patel); Kiran Patel College of Allopathic Medicine, NOVA Southeastern University, Fort Lauderdale, Florida (Mr Nasef); Louisiana State University Health Sciences Center, New Orleans, Louisiana, (Mr Baum); John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii (Mr Chin); Division of Trauma and Surgical Critical Care, Department of Surgery, Orlando Regional Medical Center, Orlando, Florida (Drs Zito and Elkbuli); and Department of Surgical Education, Orlando Regional Medical Center, Orlando, Florida (Drs Zito and Elkbuli).
在患有胸腔腹腔损伤的老年创伤患者中,输血无用度值 (TFT) 是至关重要的. 超过TFTs,特别是在创伤性脑损伤 (TBI) 患者中,显著增加死亡率和并发症,需要具体的指导方针.
科学领域:
- 创伤外科 手术 创伤外科
- 老年医学 老年医学
- 临界护理医学 临界护理医学
背景情况:
- 大规模输血在老年创伤患者中很常见.
- 缺乏对输血无用度值 (TFT) 的指导方针,特别是对于胸腹部损伤和创伤性脑损伤 (TBI).
研究的目的:
- 调查老年创伤患者 (65岁以上) 中度至重度胸部/腹部损伤的TFT.
- 分析TBI对TFT和这一群体的结果的影响.
主要方法:
- 对ACS-TQIP数据库 (2017-2021) 的回顾性队列分析.
- 包括老年创伤患者,AIS腹部/胸部≥2,有或没有TBI.
- 评估死亡率,输血量,无通风日,并发症和ICU停留时间 (ICU-LOS).
主要成果:
- 在4小时内,TFT被确定为12个单位的pRBC (非TBI) 和6个单位的pRBC (TBI).
- 在两组中,超过TFT与更高的48小时死亡率相关.
- 超过TFT的非TBI患者患有AKI和严重败血症的几率增加,以及更长的ICU-LOS.
结论:
- 超过TFT的老年创伤患者面临着明显更高的死亡风险.
- 在这种人口群体中,TFT对于指导大规模输血协议至关重要.
- 有证据支持为患有或没有TBI的老年创伤患者制定具体的大规模输血指南.
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