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机动车撞击行人与其他钝性创伤机制受害者之间确诊损伤的频率和严重程度的比较分析。

Comparative analysis of the frequency and the severity of diagnosed lesions between pedestrians struck by motor vehicles and other blunt trauma mechanisms victims.

作者信息

Parreira José Gustavo, Martins Rafael Krieger, Slongo Julio, Perlingeiro Jacqueline A Giannini, Soldá Silvia Cristine, Assef José Cesar

机构信息

Disciplina de Cirurgia de Urgência, Departamento de Cirurgia, Faculdade de Ciências Médicas da Santa Casa de São Paulo, SP, Brasil.

Departamento de Cirurgia, Irmandade da Santa Casa de Misericórdia de São Paulo, SP, Brasil.

出版信息

Rev Col Bras Cir. 2015 Jul-Aug;42(4):253-8. doi: 10.1590/0100-69912015004010.

DOI:10.1590/0100-69912015004010
PMID:26517801
Abstract

OBJECTIVE

to compare the frequency and the severity of diagnosed injuries between pedestrians struck by motor vehicles and victims of other blunt trauma mechanisms.

METHODS

retrospective analysis of data from the Trauma Registry, including adult blunt trauma patients admitted from 2008 to 2010. We reviewed the mechanism of trauma, vital signs on admission and the injuries identified. Severity stratification was carried using RTS, AIS-90, ISS e TRISS. Patients were assigned into group A (pedestrians struck by motor vehicle) or B (victims of other mechanisms of blunt trauma). Variables were compared between groups. We considered p<0.05 as significant.

RESULTS

a total of 5785 cases were included, and 1217 (21,0%) of which were in group A. Pedestrians struck by vehicles presented (p<0.05) higher mean age, mean heart rate upon admission, mean ISS and mean AIS in head, thorax, abdomen and extremities, as well as lower mean Glasgow coma scale, arterial blood pressure upon admission, RTS and TRISS. They also had a higher frequency of epidural hematomas, subdural hematomas, subarachnoid hemorrhage, brain swelling, cerebral contusions, costal fractures, pneumothorax, flail chest, pulmonary contusions, as well as pelvic, superior limbs and inferior limbs fractures.

CONCLUSION

pedestrian struck by vehicles sustained intracranial, thoracic, abdominal and extremity injuries more frequently than victims of other blunt trauma mechanism as a group. They also presented worse physiologic and anatomic severity of the trauma.

摘要

目的

比较机动车撞击行人与其他钝性创伤机制受害者的损伤诊断频率及严重程度。

方法

对创伤登记处的数据进行回顾性分析,包括2008年至2010年收治的成年钝性创伤患者。我们回顾了创伤机制、入院时的生命体征及确诊的损伤情况。使用RTS、AIS - 90、ISS和TRISS进行严重程度分层。患者被分为A组(机动车撞击行人)或B组(其他钝性创伤机制受害者)。对两组之间的变量进行比较。我们将p<0.05视为具有显著性。

结果

共纳入5785例病例,其中1217例(21.0%)属于A组。被车辆撞击的行人在年龄均值、入院时心率均值、ISS均值以及头部、胸部、腹部和四肢的AIS均值方面较高(p<0.05),而格拉斯哥昏迷量表均值、入院时动脉血压、RTS和TRISS较低。他们还具有更高频率的硬膜外血肿、硬膜下血肿、蛛网膜下腔出血、脑肿胀、脑挫伤、肋骨骨折、气胸、连枷胸、肺挫伤以及骨盆、上肢和下肢骨折。

结论

总体而言,被车辆撞击的行人比其他钝性创伤机制的受害者更频繁地遭受颅内、胸部、腹部和四肢损伤。他们的创伤在生理和解剖学严重程度方面也更严重。

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