Kreutziger Janett, Wenzel Volker, Kurz Andrea, Constantinescu Mihai Adrian
Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria.
Intensive Care Med. 2009 Jul;35(7):1234-9. doi: 10.1007/s00134-009-1446-z. Epub 2009 Feb 24.
The goal of this study was to analyse a possible association of admission blood glucose with hospital mortality of polytraumatised patients and to develop an outcome prediction model for this patient group.
The outcome of adult polytraumatised patients admitted to the University Hospital of Berne, Switzerland, between 2002 and 2004 with an ISS > or = 17, and more than one severely injured organ system was retrospectively analysed.
The inclusion criteria were met by 555 patients, of which 108 (19.5%) died. Hyperglycaemia proved to be an independent predictor for hospital mortality (P < 0.0001), following multiple regression analysis. After inclusion of admission blood glucose, the calculated mortality prediction model performed better than currently described models (P < 0.0001, AUC 0.924).
In this retrospective, single-centre study in polytraumatised patients, admission blood glucose proved to be an independent predictor of hospital mortality following regression analysis controlling for age, gender, injury severity and other laboratory parameters. A reliable admission blood glucose-based mortality prediction model for polytraumatised patients could be established. This observation may be helpful in improving the precision of future outcome prediction models for polytraumatised patients. These observations warrant further prospective evaluation.
本研究的目的是分析创伤多发患者入院时血糖水平与医院死亡率之间的可能关联,并为该患者群体建立一个预后预测模型。
对2002年至2004年间入住瑞士伯尔尼大学医院、损伤严重度评分(ISS)≥17且有一个以上严重受损器官系统的成年创伤多发患者的预后进行回顾性分析。
555例患者符合纳入标准,其中108例(19.5%)死亡。多元回归分析显示,高血糖被证明是医院死亡率的独立预测因素(P<0.0001)。纳入入院时血糖水平后,计算出的死亡率预测模型比目前描述的模型表现更好(P<0.0001,曲线下面积为0.924)。
在这项针对创伤多发患者的回顾性单中心研究中,在对年龄、性别、损伤严重程度和其他实验室参数进行回归分析后,入院时血糖水平被证明是医院死亡率的独立预测因素。可以建立一个基于入院时血糖水平的可靠的创伤多发患者死亡率预测模型。这一观察结果可能有助于提高未来创伤多发患者预后预测模型的准确性。这些观察结果值得进一步进行前瞻性评估。