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与年龄和损伤严重程度评分相匹配的对照受试者相比,糖尿病创伤患者的医院发病率更高。

Increased hospital morbidity among trauma patients with diabetes mellitus compared with age- and injury severity score-matched control subjects.

作者信息

Ahmad Rehan, Cherry Robert A, Lendel Irina, Mauger David T, Service Sara L, Texter Lindsay J, Gabbay Robert A

机构信息

Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Penn State College of Medicine, and Milton S. Hershey Medical Center, Hershey, Pennsylvania 17033, USA.

出版信息

Arch Surg. 2007 Jul;142(7):613-8. doi: 10.1001/archsurg.142.7.613.

Abstract

HYPOTHESIS

We hypothesized that patients with diabetes mellitus (DM) have worse outcomes following trauma compared with patients without a history of DM.

DESIGN

Retrospective data analysis of the Pennsylvania Trauma Systems Foundation database that compiles data from 27 accredited trauma centers in Pennsylvania.

SETTING

We used the Pennsylvania Trauma Systems Foundation database of 295 561 patients to compare outcomes in patients with DM vs those in patients who did not have DM.

PATIENTS

A total of 12 489 patients with DM from January 1984 to December 2002 were matched by sex, age, and Injury Severity Score with 12 489 patients who did not have DM.

MAIN OUTCOME MEASURES

Differences in the length of hospital stay, intensive care unit stay, ventilatory assistance days, complications, and mortality rates.

RESULTS

Patients with DM spent more days in the intensive care unit and receiving ventilator support. They were more likely to have a complication (23.0% in the DM group vs 14.0% in the non-DM group [odds ratio, 1.80; 95% confidence interval, 1.69-1.92]). No difference in mortality rates or length of hospital stay was noted.

CONCLUSION

Patients with DM exposed to trauma have greater hospital morbidity resulting from longer intensive care unit stay, increased ventilator support, and more complications.

摘要

假设

我们假设与无糖尿病病史的患者相比,糖尿病(DM)患者创伤后预后更差。

设计

对宾夕法尼亚创伤系统基金会数据库进行回顾性数据分析,该数据库汇总了宾夕法尼亚州27个经认可的创伤中心的数据。

设置

我们使用宾夕法尼亚创伤系统基金会包含295561名患者的数据库,比较糖尿病患者与非糖尿病患者的预后。

患者

1984年1月至2002年12月期间,共12489例糖尿病患者按性别、年龄和损伤严重程度评分与12489例非糖尿病患者进行匹配。

主要观察指标

住院时间、重症监护病房停留时间、通气辅助天数、并发症和死亡率的差异。

结果

糖尿病患者在重症监护病房停留时间更长,接受呼吸机支持的时间更多。他们更易发生并发症(糖尿病组为23.0%,非糖尿病组为14.0%[优势比,1.80;95%置信区间,1.69 - 1.92])。未观察到死亡率或住院时间的差异。

结论

遭受创伤的糖尿病患者因重症监护病房停留时间延长、呼吸机支持增加和更多并发症而导致更高的医院发病率。

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