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西班牙严重创伤的流行病学。重症监护病房创伤登记(RETRAUCI)。试点阶段。

Epidemiology of severe trauma in Spain. Registry of trauma in the ICU (RETRAUCI). Pilot phase.

作者信息

Chico-Fernández M, Llompart-Pou J A, Guerrero-López F, Sánchez-Casado M, García-Sáez I, Mayor-García M D, Egea-Guerrero J, Fernández-Ortega J F, Bueno-González A, González-Robledo J, Servià-Goixart L, Roldán-Ramírez J, Ballesteros-Sanz M Á, Tejerina-Alvarez E, García-Fuentes C, Alberdi-Odriozola F

机构信息

UCI de Trauma y Emergencias, Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, España.

Servei de Medicina Intensiva, Hospital Universitari Son Espases, Palma de Mallorca, España.

出版信息

Med Intensiva. 2016 Aug-Sep;40(6):327-47. doi: 10.1016/j.medin.2015.07.011. Epub 2015 Oct 4.

Abstract

OBJECTIVE

To describe the characteristics and management of severe trauma disease in Spanish Intensive Care Units (ICUs). Registry of trauma in the ICU (RETRAUCI). Pilot phase.

DESIGN

A prospective, multicenter registry.

SETTING

Thirteen Spanish ICUs.

PATIENTS

Patients with trauma disease admitted to the ICU.

INTERVENTIONS

None.

MAIN VARIABLES OF INTEREST

Epidemiology, out-of-hospital attention, registry of injuries, resources utilization, complications and outcome were evaluated.

RESULTS

Patients, n=2242. Mean age 47.1±19.02 years. Males 79%. Blunt trauma 93.9%. Injury Severity Score 22.2±12.1, Revised Trauma Score 6.7±1.6. Non-intentional in 84.4% of the cases. The most common causes of trauma were traffic accidents followed by pedestrian and high-energy falls. Up to 12.4% were taking antiplatelet medication or anticoagulants. Almost 28% had a suspected or confirmed toxic influence in trauma. Up to 31.5% required an out-of-hospital artificial airway. The time from trauma to ICU admission was 4.7±5.3hours. At ICU admission, 68.5% were hemodynamically stable. Brain and chest injuries predominated. A large number of complications were documented. Mechanical ventilation was used in 69.5% of the patients (mean 8.2±9.9 days), of which 24.9% finally required a tracheostomy. The median duration of stay in the ICU and in hospital was 5 (range 3-13) and 9 (5-19) days, respectively. The ICU mortality rate was 12.3%, while the in-hospital mortality rate was 16.0%.

CONCLUSIONS

The pilot phase of the RETRAUCI offers a first impression of the epidemiology and management of trauma disease in Spanish ICUs.

摘要

目的

描述西班牙重症监护病房(ICU)中严重创伤疾病的特征及管理情况。ICU创伤登记(RETRAUCI)。试点阶段。

设计

一项前瞻性多中心登记研究。

地点

13家西班牙ICU。

患者

入住ICU的创伤疾病患者。

干预措施

无。

主要关注变量

对流行病学、院外救治情况、损伤登记、资源利用、并发症及结局进行评估。

结果

患者共纳入2242例。平均年龄47.1±19.02岁。男性占79%。钝性创伤占93.9%。损伤严重度评分22.2±12.1,修订创伤评分6.7±1.6。84.4%的病例为非故意伤害。创伤最常见的原因是交通事故,其次是行人事故和高能坠落。高达12.4%的患者正在服用抗血小板药物或抗凝剂。近28%的患者在创伤中有疑似或确诊的中毒影响。高达31.5%的患者需要院外建立人工气道。从创伤到入住ICU的时间为4.7±5.(此处原文有误,应为5.3)3小时。入住ICU时,68.5%的患者血流动力学稳定。脑和胸部损伤最为常见。记录到大量并发症。69.5%的患者使用了机械通气(平均8.2±9.9天),其中24.9%最终需要气管切开术。在ICU和医院的中位住院时间分别为5天(范围3 - 13天)和9天(5 - 19天)。ICU死亡率为12.3%,而院内死亡率为16.0%。

结论

RETRAUCI的试点阶段提供了西班牙ICU中创伤疾病流行病学和管理情况的初步印象。

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