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2010年1月至5月海地地震后野战医院住院患者死亡相关因素

Factors associated with inpatient mortality in a field hospital following the Haiti earthquake, January-May 2010.

作者信息

Dulski Theresa M, Basavaraju Sridhar V, Hotz Gillian A, Xu Likang, Selent Monica U, DeGennaro Vincent A, Andrews David, Ford Henri, Coronado Victor G, Ginzburg Enrique

机构信息

Division of Injury Response, National Center for Injury Prevention and Control, US Centers for Disease Control and Prevention, Atlanta, Georgia, USA.

出版信息

Am J Disaster Med. 2011 Sep-Oct;6(5):275-84. doi: 10.5055/ajdm.2011.0066.

Abstract

OBJECTIVE

To describe factors associated with inpatient mortality in a field hospital established following the 2010 Haiti earthquake.

DESIGN

Data were abstracted from medical records of patients admitted to the University of Miami Global Institute/Project Medishare hospital. Decedents were compared to survivors in terms of age, sex, length of stay, admission ward, diagnosis, and where relevant, injury mechanism and surgical procedure. Three multivariate logistic regression models were constructed to determine predictors of death among all patients, injured patients, and noninjured patients.

RESULTS

During the study period, 1,339 patients were admitted to the hospital with 100 inpatient deaths (7.5 percent). The highest proportion of deaths occurred among patients aged < or = 15 years. Among all patients, adult intensive care unit (ICU) admission (adjusted odds ratio [AOR] = 7.6 and 95% confidence interval [CI] = 3.4-16.8), neonatal ICU/pediatric ICU (NICU/PICU) admission (AOR = 7.8 and 95% CI = 2.7-22.9), and cardiac/respiratory diagnoses (AOR = 8.5 and 95% CI = 4.9-14.8) were significantly associated with death. Among injured patients, adult ICU admission (AOR = 7.4 and 95% CI = 1.7-33.3) and penetrating injury (AOR = 3.3 and 95% CI = 1.004-11.1) were significantly associated with death. Among noninjured patients, adult ICU admission (AOR = 6.6 and 95% CI = 2.7-16.4), NICU/PICU admission (AOR = 8.2 and 95% CI = 2.1-31.8), and cardiac/ respiratory diagnoses (AOR = 6.5 and 95% CI = 3.6-12.0) were significantly associated with death.

CONCLUSIONS

Following earthquakes in resource-limited settings, survivors may require care in field hospitals for injuries or exacerbation of chronic medical conditions. Planning for sustained post-earthquake response should address these needs and include pediatric-specific preparation and long-term critical care requirements.

摘要

目的

描述2010年海地地震后设立的一家野战医院中与住院患者死亡率相关的因素。

设计

数据摘自迈阿密大学全球研究所/医疗共享项目医院收治患者的病历。将死亡患者与存活患者在年龄、性别、住院时间、入院科室、诊断以及相关的损伤机制和手术操作方面进行比较。构建了三个多变量逻辑回归模型,以确定所有患者、受伤患者和未受伤患者中的死亡预测因素。

结果

在研究期间,1339名患者入院,其中100名住院患者死亡(7.5%)。死亡比例最高的是年龄小于或等于15岁的患者。在所有患者中,入住成人重症监护病房(ICU)(调整优势比[AOR]=7.6,95%置信区间[CI]=3.4 - 16.8)、新生儿ICU/儿科ICU(NICU/PICU)(AOR = 7.8,95% CI = 2.7 - 22.9)以及心脏/呼吸诊断(AOR = 8.5,95% CI = 4.9 - 14.8)与死亡显著相关。在受伤患者中,入住成人ICU(AOR = 7.4,95% CI =

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