创伤性胸部损伤患者入住重症监护病房的相关因素。
Factors associated with intensive care unit admission in patients with traumatic thoracic injury.
作者信息
Lin Frank Cheau-Feng, Tsai Stella Chin-Shaw, Li Ruei-Yun, Chen Hsiao-Chien, Tung Yung-Wei, Chou Ming-Chih
机构信息
Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan, ROC.
出版信息
J Int Med Res. 2013 Aug;41(4):1310-7. doi: 10.1177/0300060513489921. Epub 2013 Jul 15.
OBJECTIVE
To identify factors associated with intensive care unit (ICU) admission in patients with traumatic thoracic injury.
METHODS
Data for consecutive patients with thoracic trauma were collected prospectively. Outcomes were requirement for ICU care and prolonged (>7 days) ICU care.
RESULTS
The study included 1333 patients, 484 (36.3%) of whom received ICU care: 125 of these (25.8%) received prolonged ICU care. Head injury, abdominal injury, injury severity score ≥ 16, haemothorax, chest tube placement and spinal surgery were significantly associated with ICU care. Head injury, number of rib fractures, chest drain placement, spinal surgery and extremity surgery were independent risk factors for prolonged ICU care.
CONCLUSIONS
Associated injury factors played a more prominent role than thoracic factors in the need for ICU and prolonged ICU care. A multidisciplinary trauma team (involving neurosurgeons, abdominal surgeons, orthopaedic surgeons and thoracic surgeons) is essential for the care of patients with traumatic thoracic injury.
目的
确定创伤性胸外伤患者入住重症监护病房（ICU）的相关因素。
方法
前瞻性收集连续的胸外伤患者的数据。结局指标为对ICU护理的需求以及延长（>7天）的ICU护理。
结果
该研究纳入了1333例患者，其中484例（36.3%）接受了ICU护理：其中125例（25.8%）接受了延长的ICU护理。颅脑损伤、腹部损伤、损伤严重程度评分≥16、血胸、胸腔闭式引流管置入和脊柱手术与ICU护理显著相关。颅脑损伤、肋骨骨折数量、胸腔闭式引流管置入、脊柱手术和四肢手术是延长ICU护理的独立危险因素。
结论
在需要ICU护理和延长ICU护理方面，相关损伤因素比胸部因素发挥着更突出的作用。多学科创伤团队（包括神经外科医生、腹部外科医生、骨科医生和胸外科医生）对于创伤性胸外伤患者的护理至关重要。
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