利用国家创伤数据库预测结果：钝性颈动脉创伤和钝性胸部损伤的优化管理
Predicting outcomes using the National Trauma Data Bank: optimum management of traumatic blunt carotid and blunt thoracic injury.
作者信息
Dua Anahita, Desai Sapan S, Kuy SreyRam, Patel Bhavin, Dua Arshish, Desai Pathik J, Darlow Matthew, Shirgavi Jay, Charlton-Ouw Kristofer, Shortell Cynthia
机构信息
University of Texas at Houston, TX, USA.
出版信息
Perspect Vasc Surg Endovasc Ther. 2012 Sep;24(3):123-7. doi: 10.1177/1531003513482492. Epub 2013 Mar 26.
INTRODUCTION
We used the National Trauma Data Bank (NTDB) to examine the incidence of blunt thoracic and carotid trauma nationally and survival outcomes based on treatment approach.
METHODS
All vascular traumas were identified from the 2008 NTDB. International Classification of Diseases, 9th Revision (ICD-9) diagnosis coding was used to identify 178 blunt thoracic aortic injuries and 313 traumatic blunt carotid injuries.
RESULTS
In all, 2089 vascular traumas were identified. Patients with blunt thoracic trauma within the highest injury severity score (ISS) range (61-75) had a significant survival advantage when observation was compared with endovascular management (P < .05). In the carotid trauma cohort, those with the highest ISS range (61-75) had a significant survival advantage with open surgery compared with observation (P < .01).
CONCLUSION
Patients with traumatic blunt thoracic injury and an ISS > 61 appeared to benefit from endovascular approaches compared with open management. Patients with blunt carotid trauma and an ISS > 61 appeared to benefit from open surgical management.
引言
我们使用国家创伤数据库（NTDB）来研究全国钝性胸主动脉和颈动脉创伤的发生率以及基于治疗方法的生存结果。
方法
从2008年NTDB中识别出所有血管创伤。使用国际疾病分类第九版（ICD-9）诊断编码来识别178例钝性胸主动脉损伤和313例创伤性钝性颈动脉损伤。
结果
总共识别出2089例血管创伤。在损伤严重程度评分（ISS）最高范围（61 - 75）内的钝性胸外伤患者，与血管内治疗相比，观察时具有显著的生存优势（P <.05）。在颈动脉创伤队列中，ISS最高范围（61 - 75）的患者与观察相比，开放手术具有显著的生存优势（P <.01）。
结论
与开放治疗相比，钝性胸外伤且ISS > 61的患者似乎从血管内治疗方法中获益。钝性颈动脉创伤且ISS > 61的患者似乎从开放手术治疗中获益。
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