Santana-Cabrera Luciano, Sánchez-Palacios Manuel, Rodríguez Alina Uriarte
Department of Intensive Care, Universitary Hospital Insular in Gran Canaria Las Palmas de Gran Canaria, Spain.
Int J Burns Trauma. 2013 Nov 1;3(4):220-4. eCollection 2013.
Objetive. To find the differences between the prognosis of the patients with severe traumatism injury and those who were admitted with medical pathology who also required mechanical ventilation in our ICU. Patients and Method. Retrospective descriptive study in a polyvalent ICU of a third level hospital for a period of 8 years. Epidemiological variables such as age, sex, average stay, mortality, APACHE II at admission and days of mechanical ventilation, were analyzed in patients with severe traumatism injury and patients with medical pathology that were admitted in ICU and received mechanical ventilation during this period. Results. During the study period were admitted 208 patients with severe traumatism injury and 732 medical patients, all of them required mechanical ventilation. Patients with severe traumatism injury are more younger (41.8 vs 55.3 years, p = 0.001) and entered ICU in a state of minor severity, according to the prognostic index APACHE II (14.8 vs 17.4, p < 0.001), despite which they required more days of mechanical ventilation (9.8 vs 7.8 days, p = 0.017) and had a higher average stay (11.4 vs 9.4 days, p = 0.027), although the mortality was significantly lower (38.2% vs 28.2%, p = 0.005). Multivariate analysis showed as independent variables associated with mortality, the APACHE II (p < 0.0001), the average stay in ICU (p < 0.0001), days of mechanical ventilation (p < 0.0001) and type patient (p = 0.016). Conclusions. Patients with severe traumatic injury that require mechanical ventilation despite to be admitted in ICU in a state of greater severity, having an increased ICU stay and more days of mechanical ventilation, have a better prognosis than medical patients that required also mechanical ventilation at ICU stay, likely to be younger.
目的。找出在我们的重症监护病房（ICU）中，严重创伤患者与因内科疾病入院且同样需要机械通气的患者在预后方面的差异。患者与方法。在一家三级医院的综合ICU进行了为期8年的回顾性描述性研究。分析了在此期间入住ICU并接受机械通气的严重创伤患者和内科疾病患者的流行病学变量，如年龄、性别、平均住院时间、死亡率、入院时的急性生理与慢性健康状况评分系统（APACHE II）以及机械通气天数。结果。在研究期间，共收治了208例严重创伤患者和732例内科患者，所有患者均需要机械通气。严重创伤患者更年轻（41.8岁对55.3岁，p = 0.001），根据预后指标APACHE II，入院时病情较轻（14.8对17.4，p < 0.001），尽管如此，他们需要更长时间的机械通气（9.8天对7.8天，p = 0.017），平均住院时间也更长（11.4天对9.4天，p = 0.027），不过死亡率显著更低（38.2%对28.2%，p = 0.005）。多变量分析显示，与死亡率相关的独立变量包括APACHE II（p < 0.0001）、在ICU的平均住院时间（p < 0.0001）、机械通气天数（p < 0.0001）和患者类型（p = 0.016）。结论。尽管严重创伤患者入院时病情较重，但需要机械通气，其在ICU的住院时间延长且机械通气天数增多，然而预后却比同样在ICU需要机械通气的内科患者更好，可能是因为他们更年轻。
