Pillgram-Larsen J, Solheim K, Birkeland S
Kirurgisk klinikk, Ullevål sykehus, Oslo.
Tidsskr Nor Laegeforen. 1992 Feb 10;112(4):485-8.
A prospective registration was carried out of all patients with multiple injuries who were admitted to hospital in 1990 during the first 24 hours after the accident. The total number was 441, and included 47 patients with penetrating injuries. Such patients constituted 5% of a total of 9,000 admitted patients, and 19% of a total of 2,266 injured persons. The injuries were scored using the Trauma Score and Injury Severity Score and the probability for survival was calculated by the TRISS method. 148 patients were seriously injured, having an Injury Severity Score 16 or more. Traffic accidents were more common, and were the cause of injury in more than 50% of the patients. 15% of the patients with such injuries were under the influence of alcohol and 5% were drug abusers. The percentage under the influence of alcohol was three times as high, however, among patients injured by violence. Median ISS was 26 for the whole series, and 41 for the 41 patients who died. Mortality was significantly higher in patients older than 54 years of age than among younger patients. No patients were reduced to a vegetative state, but 13% of the surviving patients were considerably disabled. Among the 41 patients who died the main cause of death was haemorrhage in 17, and airway obstruction in five. Estimation of probability of survival showed that the mortality in this series compared well with the mortality in larger series of injured persons in America. None the less, improvement is still feasible.
对1990年事故发生后最初24小时内入院的所有多发伤患者进行了前瞻性登记。总数为441例，其中包括47例穿透伤患者。这类患者占9000例入院患者总数的5%，占2266例受伤人员总数的19%。使用创伤评分和损伤严重度评分对损伤进行评分，并通过TRISS方法计算生存概率。148例患者受重伤，损伤严重度评分为16分或更高。交通事故更为常见，是50%以上患者的受伤原因。15%的此类受伤患者受酒精影响，5%为药物滥用者。然而，在因暴力受伤的患者中，受酒精影响的比例高出三倍。整个系列的损伤严重度评分中位数为26分，41例死亡患者的评分为41分。54岁以上患者的死亡率明显高于年轻患者。没有患者进入植物人状态，但13%的存活患者有严重残疾。在41例死亡患者中，主要死亡原因是17例出血和5例气道阻塞。生存概率估计表明，该系列的死亡率与美国更大系列受伤人员的死亡率相当。尽管如此，仍有改进的空间。
