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高处坠落致死后的预后因素。

Prognostic factors for mortality following falls from height.

机构信息

Division of Trauma of Emergency Department, Taipei Veterans General Hospital, Shih-pai Road, Taipei 112, Taiwan.

出版信息

Injury. 2009 Jun;40(6):595-7. doi: 10.1016/j.injury.2008.11.014. Epub 2009 Apr 17.

Abstract

AIM

To identify the potential prognostic factors for mortality after falls from height.

METHOD

A retrospective clinical observational study included victims of fall of >6m from October 2000 to December 2007. Variables studied comprised each casualty's age, gender, height of fall, Glasgow Coma Scale (GCS) score, Abbreviated Injury Scale scores, Injury Severity Score, heart rate, Mean Arterial Pressure (MAP), White Blood Cell (WBC) count, haemoglobin, serum glucose, Creatine Kinase and duration of hospital stay. The relationships between these variables and outcomes were evaluated.

RESULTS

Among the 66 patients studied the mortality rate was 22.7%, i.e. 7 out-of-hospital and 8 in-hospital deaths. In univariate analysis, Glasgow Coma Score < or =14, Injury Severity Score > or =16, head/neck Abbreviated Injury Scale score > or =4, chest Abbreviated Injury Scale score > or =4, heart rate > or =100 or < or =50 beats/min, Mean Arterial Pressure < or =60 and serum glucose > or =140 mg/dl were significantly related to mortality. In multivariate analysis, head/neck Abbreviated Injury Scale score > or =4 was independently correlated with mortality.

CONCLUSIONS

Severe head injury (head/neck Abbreviated Injury Scale score > or =4) is a significant factor for mortality following falls from >6 m.

摘要

目的

确定高处坠落伤后死亡率的潜在预后因素。

方法

本回顾性临床观察性研究纳入了 2000 年 10 月至 2007 年 12 月间坠落高度>6m 的受害者。研究的变量包括每个伤员的年龄、性别、坠落高度、格拉斯哥昏迷评分(GCS)、简明损伤评分、损伤严重程度评分、心率、平均动脉压(MAP)、白细胞计数(WBC)、血红蛋白、血清葡萄糖、肌酸激酶和住院时间。评估了这些变量与结局之间的关系。

结果

在所研究的 66 例患者中,死亡率为 22.7%,即 7 例院外死亡和 8 例院内死亡。在单因素分析中,格拉斯哥昏迷评分≤14、损伤严重程度评分≥16、头部/颈部简明损伤评分≥4、胸部简明损伤评分≥4、心率≥100 或≤50 次/分、平均动脉压≤60mmHg 和血清葡萄糖≥140mg/dl 与死亡率显著相关。多因素分析显示,头部/颈部简明损伤评分≥4 与死亡率独立相关。

结论

严重头部损伤(头部/颈部简明损伤评分≥4)是高处坠落伤后死亡率的一个重要因素。

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