影响重症监护室患有胸部创伤患者死亡率和临床结果的因素:一项回顾性单中心研究
Yeşim Şerife Bayraktar1, Tuba Şahinoğlu2, Yasemin Cebeci3
1Division of Intensive Care, Department of Anesthesiology and Reanimation, Selçuk University Faculty of Medicine, Konya 42130, Turkey.
Medicina (Kaunas, Lithuania)
|February 27, 2026
概括
高龄,女性性别和格拉斯哥昏迷量表 (GCS) 的较低分数是胸部创伤患者死亡的关键风险因素. 急性生理学和慢性健康评估II (APACHE II) 评分是重症监护病房 (ICU) 存活率的最强预测指标.
科学领域:
- 关键护理医学 关键护理医学
- 创伤外科 手术 创伤外科
- 重症监护病房 (ICU) 管理管理
背景情况:
- 胸部创伤是导致死亡的重要原因,特别是在年轻人中.
- 鉴定患有胸部创伤的ICU患者死亡率的风险因素和预测因素对于改善结果至关重要.
研究的目的:
- 为了确定重症监护室 (ICU) 患有胸部创伤的患者死亡的风险因素.
- 评估影响该患者群体临床结果和并发症的因素.
- 为了确定伤害严重性得分 (ISS),APACHE II和GCS对死亡率的预测值.
主要方法:
- 追溯性,单中心研究,包括104名成年胸部创伤患者入院ICU.
- 患者被分为幸存者和非幸存者.
- 分析包括人口统计数据,临床参数,并发症,伤害严重程度评分 (ISS),APACHE II和格拉斯哥昏迷量表 (GCS).
主要成果:
- 死亡率与晚年,女性性别,较低的GCS,较高的APACHE II分数和头部创伤等并发症有关.
- 不幸存者需要更多的机械呼吸,血管压力器支持和持续的置换疗法,VAP和ARDS的比例更高.
- 在APACHE II评分中,死亡率的歧视性表现最高 (AUC = 0.751),年龄和乳糖也是强有力的预测因素. 基于APACHE II的模型显示了高精度 (88.5%).
结论:
- 根据APACHE II得分的指标,晚年和生理障碍是生存的更重要的决定因素,而不仅仅是受伤严重程度.
- 诸如感染控制,酸性纠正和血液动力稳定等因素可能会减少ICU停留时间和死亡率.
- 与ISS和GCS相比,APACHE II评分是胸部创伤患者整体临床严重程度和死亡率的更强有力的预测指标.
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